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Introduction: Febrile seizures are seizure episodes that occur due to an increase in body temperature above 38°C without evidence of central nervous system infection such as meningitis or encephalitis. In Indonesia, the prevalence of febrile seizures is approximately 2–5% among children aged 6 months to 3 years, and around 30% of these cases experience recurrence or recurrent febrile seizures. Therefore, an appropriate nursing care plan is required to manage patients with febrile seizures. Methods: This scientific paper employed a descriptive narrative method to illustrate the provision of nursing care to patients through the nursing process approach. The general objective of this study was to understand and implement nursing care for patients with febrile seizures. Results: The nursing diagnoses identified in patients with febrile seizures were hyperthermia, risk for injury, and knowledge deficit. Nursing interventions included hyperthermia management, safety management, and health education. Conclusion: After two days of nursing implementation, two nursing diagnoses were resolved and one was partially resolved. Discharge planning included monitoring the patient's condition, particularly for seizure signs, maintaining a safe environment, educating the family about injury prevention during seizures, and encouraging family members to continuously supervise the patient.

Background: Gout arthritis is a metabolic disease caused by excessive uric acid levels in the blood (hyperuricemia), which leads to monosodium urate crystal deposition in the joints. Globally, the prevalence of gout arthritis ranges from 1–4% of the general population. In Indonesia, the national prevalence reaches approximately 7.3% based on medical diagnosis, and in Brebes Regency, cases reach 62.4%. At the Tonjong Health Center service area, the prevalence of gout arthritis in Karanganyar Hamlet, Tonjong Village, reaches 2.04%. Gout arthritis requires comprehensive nursing care including pain management and health education to prevent recurrence. Objective: To implement nursing care for Ny. S, family of Tn. S, with musculoskeletal system disorder: gout arthritis in Karanganyar Hamlet, Tonjong Village, Tonjong District, Brebes Regency. Method: This study used a case study design with a single patient/family subject. Data collection was conducted through interview, observation, physical examination, and study documentation on December 26–27, 2025 at the patient's home. Results: Assessment revealed Ny. S (72 years) experienced acute pain in the right knee joint with a pain scale of 3/10 and uric acid level of 7.3 mg/dL, along with knowledge deficit regarding gout arthritis. Two nursing diagnoses were established: acute pain and knowledge deficit. Nursing interventions included pain management education, non-pharmacological therapy (turmeric decoction), pharmacological therapy (allopurinol), and health education. Implementation was conducted over two visits. Evaluation results showed that acute pain was partially resolved (pain scale reduced to 2/10, uric acid 7.2 mg/dL) and knowledge deficit was resolved. Conclusion: Nursing care for patients with gout arthritis through pain management and health education can reduce pain intensity and improve family knowledge about the disease. Non-pharmacological intervention with turmeric decoction contributed to decreasing uric acid levels and pain. Keywords: gout arthritis, acute pain, knowledge deficit, family nursing care, non-pharmacological therapy

Circulating tumor DNA (ctDNA) has emerged as a promising liquid biopsy biomarker for real-time monitoring of tumor dynamics. In urothelial carcinoma (UC), effective monitoring of treatment response remains a clinical challenge due to the limitations of conventional imaging and invasive procedures. This systematic review aims to synthesize the existing evidence on the association between ctDNA dynamics and treatment response monitoring across various stages and therapeutic settings. A comprehensive systematic review was conducted. We included cohort studies, randomized controlled trials, and meta-analyses that evaluated ctDNA in UC patients undergoing treatment. Data were extracted on patient population, methodology, treatment, sampling strategy, clinical outcomes, and statistical associations. The review encompassed 80 studies. Baseline ctDNA positivity was strongly prognostic, associated with a 4- to 6-fold increased risk of recurrence or death (HR 4.23-6.56). Dynamic ctDNA clearances or significants reduction during treatment, were strongly associated with improved outcomes. Showing hazard ratios for adverse events as low as 0.10-0.31. ctDNA demonstrated time advantages of 53-90 days over radiographic detection. ctDNA is a potent tool for monitoring treatment response in urothelial carcinoma. It provides superior prognostic and offers a significant lead time for detecting treatment failure. Future research must focus on standardizing methodologies and validating ctDNA-guided therapeutic.

Iron deficiency anemia (IDA) is a condition of insufficient iron that lowers hemoglobin levels and disrupts erythrocyte formation. This condition commonly occurs in children and can weaken the immune system, thereby increasing the risk of recurrent respiratory tract infections such as bronchiolitis, pneumonia, and Acute Respiratory Tract Infections (ARTI). Children with IDA are also at risk of worsening clinical conditions. This study employed a literature review method with a descriptive-analytical approach. A total of 10 journals (2020–2026) from Google Scholar, PubMed, ResearchGate, Elsevier, and the National Center for Biotechnology Information (NCBI) were analyzed using the Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework and synthesized narratively. The results of the review indicate that iron deficiency anemia is significantly associated with an increased risk of recurrent respiratory tract infections in children. Children with IDA have a 2–5 times higher risk of developing bronchiolitis and pneumonia, and up to 10 times greater susceptibility to recurrent ARTI. This condition is also associated with increased disease severity, characterized by low hemoglobin levels, mean corpuscular volume (MCV), and serum iron, as well as elevated total iron-binding capacity (TIBC). Iron supplementation has been proven effective in reducing the incidence of recurrent infections. In conclusion, iron deficiency anemia is associated with an increased risk and severity of recurrent respiratory tract infections in children. Early detection and iron supplementation are essential to reduce morbidity and prevent infection recurrence.

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.

Vertigo is a clinical symptom that is often found and can be related to vestibular disorders or systemic conditions such as hypertension. The case report described a 58-year-old female patient who came in with complaints of dizziness that disappeared from 12 hours before admission to the hospital, accompanied by double vision, nausea, severe headache, flatulence, and stiffness of the left shoulder. Physical examination showed increased blood pressure and bidirectional nystagmus on neurological examination. Laboratory tests show mild electrolyte abnormalities and increased cholesterol. The patient was diagnosed with uncontrolled vestibular vertigo et causa hypertension and received intravenous fluid therapy, symptomatic therapy, antihypertensive therapy, and vestibular suppressants. Clinical improvements were obtained during follow-up. Education related to blood pressure control, medication adherence, and lifestyle changes such as low-salt diet settings and stress management is also provided to patients. In addition, periodic monitoring is required to prevent recurrence and further complications. This case emphasizes the importance of identifying hypertension as a contributing factor to vertigo as well as comprehensive management to improve patient outcomes and improve the quality of life of patients.

Supraventricular tachycardia (SVT) is one of the most common arrhythmias in the pediatric population, often resulting from re-entry mechanisms involving accessory pathways or dual atrioventricular nodal physiology. Although generally well tolerated in children with structurally normal hearts, its management can be challenging, particularly in recurrent or persistent cases. This study is a case report describing a pediatric patient with hemodynamically stable SVT treated at Dr. Wahidin Sudirohusodo Hospital. Data were collected retrospectively from medical records, including history taking, physical examination, and supporting investigations such as serial electrocardiography (ECG), laboratory tests, chest radiography, and transthoracic echocardiography. Management was conducted according to current clinical guidelines, including vagal maneuvers, pharmacological therapy with beta-blockers and antiarrhythmic agents (amiodarone), and monitoring of treatment response based on clinical evaluation and ECG, along with identification and treatment of underlying triggers. We report a case of a 10-year-old female presenting with suspected SVT and pericarditis, who experienced episodes of narrow QRS complex tachycardia that were successfully converted to sinus rhythm following amiodarone administration. Echocardiographic evaluation revealed mild to moderate tricuspid regurgitation with preserved ventricular function. Laboratory and radiological findings suggested an underlying inflammatory process, which was considered a triggering factor. This case highlights the importance of a comprehensive approach in the diagnosis and management of pediatric SVT, including addressing underlying conditions and ensuring continuous monitoring to prevent recurrence.

The economy of a country, including Indonesia, is a system that encompasses all production, distribution, and consumption activities occurring within the country. In the economy, problems often arise that can affect the welfare of society. The problem formulation in this study is: How is the regulation and supervision of both internal and external banks carried out to prevent customer personal data leakage in credit agreements? And how is the responsibility of BPR Karya Sari Sedana towards the leakage of customer debtor data? The research method used is empirical legal research. The conclusion in the study is the protection of customer data against personal data leakage by understanding the forms of supervision from both internal and external parties conducted by the banking institution and referring to the OJK regulations that have been established, in order to minimize the recurrence of similar incidents and allow the public to conduct transactions safely without worrying about their personal data. Leaked by irresponsible individuals. The responsibility carried out by the banking sector currently, namely the Financial Services Authority Regulation Number 22 of 2023 concerning Consumer and Community Protection in the Financial Services Sector, also regulates consumer protection in the financial services industry. Forms in policies related to regulations in the banking world ensure that the public does not worry about their personal data.

The phenomenon of recidivism in narcotics crimes indicates that the rehabilitation and punishment approaches applied have not been fully able to prevent recurrence of crimes. This study aims to analyze the effectiveness of law enforcement against recidivists in narcotics crimes in two court decisions, namely Decision Number 154/Pid.Sus/2018/PN Yyk and Decision Number 51/Pid.Sus/2020/PN Tte. Case studies are used to assess the effectiveness of law enforcement, especially against perpetrators who have previously undergone rehabilitation but have re-committed crimes with more complex roles. This study uses a normative legal method with a statutory approach and a case approach, which are analyzed qualitatively based on law enforcement theory and the objectives of punishment. The results show that normatively there are regulations on rehabilitation and increased sentences for recidivists, but their effectiveness is not optimal, partly due to the lack of post-rehabilitation regulations that are expressly regulated in the law and the lack of integrated data systems between rehabilitation institutions and the courts. This condition causes rehabilitation to not fully function as a preventive instrument against recurrence of crimes. This study recommends strengthening post-rehabilitation regulations and integrating information systems between agencies as part of a more preventive and sustainable criminal law policy reform.

Dermoid cyst is a benign congenital choristoma frequently found in the periocular region, particularly in children. It results from ectodermal tissue sequestration along embryonic fusion lines. Although generally benign and slow-growing, dermoid cysts may cause cosmetic deformity, mechanical ptosis, or visual disturbance if left untreated. A 4-year-old child presented with a painless, slowly enlarging mass on the upper eyelid that had been noticed since early childhood. Physical examination revealed a well-circumscribed, firm, non-tender mass without signs of inflammation. Visual acuity was within normal limits, and no proptosis was observed. Clinical findings were consistent with a superficial eyelid dermoid cyst. The patient underwent complete surgical excision under general anesthesia. Intraoperatively, the cyst was removed intact without rupture. Histopathological examination confirmed a dermoid cyst characterized by keratinized stratified squamous epithelium lining with adnexal skin structures. Postoperative recovery was uneventful, with good cosmetic outcome and no recurrence during follow-up. Eyelid dermoid cyst can be diagnosed clinically through careful history taking and physical examination. Complete surgical excision is the definitive treatment and provides excellent functional and cosmetic outcomes. Early management is recommended to prevent potential complications and to achieve optimal results.

Syncope or fainting is an emergency condition that commonly occurs during sports activities due to reduced blood flow and oxygen to the brain. Rapid and appropriate management is essential to prevent further complications. This study aims to determine the syncope management procedures following sports activities performed by healthcare professionals at primary healthcare facilities. This study employed direct observation and structured interviews with healthcare workers at Puskesmas Boba, Ngada on November 28, 2025. Observed aspects included initial patient condition, initial actions, vital signs examination, medical assistance provision, condition monitoring, and follow-up actions. Healthcare workers performed management according to first aid procedures by positioning patients supine, elevating both legs, loosening tight clothing, checking vital signs using sphygmomanometer and stethoscope, providing oxygen and fluids when necessary, and monitoring until condition stabilized. Main causative factors of syncope were dehydration, physical fatigue, hypoglycemia, and anemia. Syncope management requires systematic actions and adequate medical equipment. Preventive education for athletes and the community, as well as collaboration among healthcare workers, coaches, and physical education teachers is crucial to prevent recurrence.

The 2018 financial statement manipulation case of PT Garuda Indonesia Tbk revealed a violation of the ethical principles of the public accountant profession and weak auditor independence in detecting irregularities in revenue recognition. This incident has created an urgency to empirically test the extent to which professional ethics influence auditor independence in preventing financial statement manipulation. This study aims to analyze the influence of public accountant professional ethics on auditor independence using quantitative research methods. Data were obtained through variable measurements using structured instruments which were then processed and analyzed using the SPSS application through validity tests, reliability tests, simple linear regression analysis, and t-tests to determine the significance of the influence between variables. The results of the study indicate that professional ethics has a positive and significant influence on auditor independence, where the stronger the application of ethical principles, the higher the level of auditor independence in carrying out their professional duties. The conclusion of this study confirms that the consistent application of professional ethics is a fundamental factor in maintaining auditor objectivity and preventing the recurrence of financial statement manipulation cases such as those that occurred at PT Garuda Indonesia Tbk.

The rapid growth of Indonesia’s digital economy has created opportunities while simultaneously increasing the risk of monopolistic practices and unfair business competition. To address these issues, the Business Competition Supervisory Commission (KPPU) introduced behavioral remedies as an alternative dispute settlement mechanism. This study aims to analyze the effectiveness of behavioral remedies in cases of market control and abuse of dominant position. The research employs a doctrinal legal method. Effectiveness is assessed through two main indicators, namely the restoration of market conditions and the prevention of repeated violations. The findings show that this mechanism is generally effective in restoring competition and preventing recurrence, as demonstrated in several KPPU cases, including Case No. 04/KPPU-I/2024. However, its effectiveness remains conditional, as the mechanism is reactive, does not impose fines, and is monitored only for a relatively short period. Moreover, although KPPU Regulation No. 2 of 2023 regulates this mechanism, it does not provide sufficient legal explanation regarding the classification of articles that are permitted. Therefore, stronger monitoring and more detailed legal clarification are required to ensure the sustainable effectiveness of this mechanism in maintaining fair competition.

Infertility affects approximately 8–12% of couples worldwide, with male factors contributing to nearly half of all cases. Varicocelectomy, particularly the microsurgical subinguinal technique, is now considered the primary treatment that provides superior reproductive outcomes compared to conventional or laparoscopic approaches. To evaluate and compare fertility outcomes and recurrence risks between microsurgical and conventional inguinal varicocelectomy, based on recent evidence from 2020 to 2025. Methods A systematic review was conducted using databases including PubMed, Scopus, Cochrane, ScienceDirect, and Google Scholar. Out of 371 identified articles, 9 studies met the inclusion criteria. Results, most studies demonstrated that the microsurgical technique significantly improved sperm concentration, motility, and morphology, as well as higher natural pregnancy rates. The risks of hydrocele and recurrence were also markedly lower than those observed with laparoscopy. The average postoperative sperm count increased by 7.7 ± 4.5 million/mL (p< 0.001). Furthermore, the microsurgical subinguinal approach allows for more precise identification of arteries and lymphatic vessels, thereby minimizing vascular injury and facilitating faster recovery. Conclusion, the microsurgical subinguinal varicocelectomy has proven to be more effective and safer than conventional approaches. This technique significantly enhances semen parameters and pregnancy rates, while reducing the risk of hydrocele formation and recurrence.

Schizophrenia is a serious mental illness that requires long-term treatment and carries a high risk of recurrence. The recovery process for patients relies not only on medical intervention, but also requires optimal involvement and support from their families. The presence of a supportive family is believed to strengthen patient motivation and contribute positively to their psychological well-being. This study aims to identify the relationship between family support and relapse rates in schizophrenia patients undergoing treatment at the Aceh Mental Hospital Polyclinic. This study uses a correlational design with a Cross-Sectional method. Through Accidental Sampling, 114 samples were selected from a population of 3,233 individuals. Data collection took place between April 14 and 28, 2025, using a questionnaire focused on family support and relapse rates. To analyze the relationship between the two variables, a Chi-Square statistical test was applied. The main findings of the study show that aspects of family support in general (p=0.000), informational support (p=0.000), appreciative support (p=0.000), instrumental support (p=0.001), and emotional support (p=0.002) are correlated with the recurrence rate of patients. Based on the analysis of the results, it can be concluded that there is a correlation between family support and the recurrence of schizophrenia patients at the Aceh Mental Hospital Polyclinic. The practical implications of this research are expected to serve as a reference for the families of schizophrenia patients to increase their understanding and activity in providing support, including consulting with mental health professionals as an effort to prevent possible recurrence.

Recurrent aphthous stomatitis (RAS) is a common inflammatory condition of the oral mucosa characterized by round or oval ulcers with well-defined reddish borders and a shallow base covered by a grayish or yellowish fibrinous pseudomembrane. RAS is generally classified into three clinical types—minor, major, and herpetiform based on the size, number, and duration of the lesions. Several factors contribute to its occurrence, including bacterial infections such as Streptococcus sanguis, immune system dysfunctions, and nutritional deficiencies involving iron, vitamin B12, and folic acid. Other potential triggers include local trauma, hormonal or endocrine imbalances, psychological stress, and allergic reactions. Among these, anemia due to deficiencies in iron, folate, or vitamin B12 is considered an important etiopathogenic factor, although its exact role has not been fully clarified. The management of RAS primarily focuses on symptom relief, promoting faster ulcer healing, and preventing recurrence through both topical and systemic approaches. Effective treatment often includes improving nutritional intake, maintaining oral hygiene, and addressing underlying systemic or psychological conditions. Understanding the multifactorial causes of RAS is crucial in developing comprehensive strategies for prevention and long-term management of this recurrent oral lesion.

This study evaluates the retrofit design of the Semat weir on the Kali Gawe in Jepara Regency. The retrofit aims to adjust the weir’s hydraulic capacity to accommodate estimated flood discharges while ensuring the structure’s stability under applied loads. In the agricultural context, adequate water availability for irrigation directly affects crop yields; conversely, the rainy season often increases river flow and flood risk. Irrigation structures such as weirs are therefore required to raise river water levels to divert flow into irrigation channels and to regulate water distribution. Flood discharge estimates were derived from precipitation data and watershed (drainage basin) characteristics. Flood hydrograph planning is a critical design step for the weir. Log-Pearson Type III analysis was used to determine probable precipitation values for several recurrence intervals. Those design precipitation values were then converted into design flood discharges using synthetic unit hydrograph methods, specifically the Snyder, Nakayasu, and Gamma HSS approaches. Employing the Gamma synthetic unit hydrograph for the 50-year return period (Q50) produced a design flood discharge of 2,536.52 m³/s for that recurrence interval. Structural stability analyses of the redesigned weir indicate safety factors well above customary thresholds: overturning resistance factor = 11.6 (required ≥ 1.5), sliding resistance factor = 4.80 (required ≥ 2.0), and piping (internal erosion) factor = infinite (required ≥ 4). All evaluated stability parameters therefore satisfy standard safety criteria.

Bell's Palsy is a sudden onset of peripheral facial nerve paralysis that is generally unilateral. This condition is characterized by facial muscle weakness, asymmetry, difficulty closing the eyes, and facial expression disorders. Associated risk factors include exposure to cold temperatures and the habit of chewing ice cubes, which can trigger vasospasm of the blood vessels and inflammation of the facial nerve.  Physiotherapy management is important to accelerate recovery, prevent complications such as synkinesis and contractures, and improve the patient's quality of life. This study aims to describe the implementation of physiotherapy in cases of Bell's Palsy at PKU Muhammadiyah Selogiri Hospital and evaluate the effectiveness of physiotherapy intervention on the recovery of facial function in patients. A case report was conducted on a 41-year-old female patient diagnosed with right-sided Bell's Palsy. The examination included anamnesis, static and dynamic inspection, palpation, basic movement examination, sensory examination, and assessment using the House-Brackmann Facial Grading System (HBGS). Physiotherapy interventions were given three times a week, including Infra Red (IR), Transcutaneous Electrical Nerve Stimulation (TENS), light massage, facial exercises (raising eyebrows, closing eyes, blowing, smiling), and education on preventing exposure to cold. Evaluation was performed using Manual Muscle Testing (MMT) and Ugo Fisch. The implementation of physiotherapy with a combination of IR, TENS, massage, and facial exercises is effective in gradually improving the facial function of patients with Bell's Palsy. Physiotherapy also plays a role in educating patients about the prevention of recurrence related to environmental risk factors and lifestyle.

Cardiac arrest is a medical emergency that results in the sudden cessation of heart function, leading to more than 7 million deaths worldwide annually. In Indonesia, its prevalence is not well-documented. Ischemic heart disease is the primary cause, with other risk factors like hypertension, diabetes, obesity, and smoking also contributing. Clinical signs include loss of responsiveness, impaired breathing, and the absence of a pulse. Diagnosis is based on history, physical examination, electrocardiography, laboratory tests, and imaging to determine the underlying cause. Treatment follows the 2020 American Heart Association (AHA) guidelines, starting with basic life support (BLS), followed by Advanced Cardiac Life Support (ACLS). ACLS includes high-quality cardiopulmonary resuscitation (CPR), early defibrillation for shockable rhythms, epinephrine administration, and airway management through intubation. Once Return of Spontaneous Circulation (ROSC) is achieved, post-cardiac arrest care is crucial, including hemodynamic stabilization, Targeted Temperature Management (TTM), and critical care to prevent recurrence and neurological damage. A clear understanding of cardiac arrest's diagnosis, risk factors, and management is vital for reducing mortality. Adherence to AHA guidelines, especially rapid resuscitation, improves survival rates, making continuous CPR education essential for healthcare providers and the public.

  Medication adherence among pulmonary TB patients is crucial to prevent recurrence and ensurecomplete recovery. Patient knowledge of tuberculosis treatment and adherence to prescribed dosages andadministration methods are key components to successful treatment. This study aimed to determine therelationship between knowledge and medication adherence in pulmonary TB patients at Harapan Anda IslamicHospital, Tegal City. This study used a quantitative cross-sectional design. A sample size of 60 pulmonary TBpatients at Harapan Anda Islamic Hospital, Tegal City, was selected through purposive sampling. Data werecollected using a knowledge questionnaire and a medication adherence questionnaire. Data were analyzed usingthe chi-square test. Based on the analysis results, it was found that of the 60 patients with pulmonary TB atHarapan Anda Islamic Hospital, Tegal City, most were in the early elderly age (46-55 years), most were malebecause they were men, the majority were married, most had graduated from high school and most had privateemployment status. The level of compliance with taking medication in patients with pulmonary TB at HarapanAnda Islamic Hospital, Tegal City was in the high category. There was a relationship between the level ofknowledge and compliance with taking medication in patients with pulmonary TB at Harapan Anda IslamicHospital, Tegal City. There was a relationship between the level of knowledge and compliance with takingmedication in patients with pulmonary TB at Harapan Anda Islamic Hospital, Tegal City. Patients who had goodknowledge tended to be more compliant in undergoing treatment. These results serve as input for health servicesto provide health service programs to improve knowledge and compliance with taking medication in patients withpulmonary TB better.