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This case report examines the effectiveness of a combined pulmonary rehabilitation and musculoskeletal physiotherapy program for a 26-year-old male post-pulmonary tuberculosis patient with lumbar tuberculous spondylitis. The patient, who had completed anti-tuberculosis treatment, presented with low back pain, shortness of breath, fatigue, and limited mobility. Spirometry indicated severe restrictive ventilatory impairment (FVC 1.28 L, 32% of predicted), and lower extremity muscle strength was reduced (MMT 2-3/5). The patient used a TLSO brace and walking aid. Over a three-week physiotherapy program, the patient participated in breathing exercises, spinal mobilization, muscle strengthening, functional exercises, and education on brace use. Evaluation occurred at the first, second, and third weeks. After treatment, pain intensity decreased from VAS 6 to VAS 3, FVC improved to 1.72 L, chest expansion increased, muscle strength improved to MMT 4/5, and performance on the Five-Times Sit-to-Stand Test showed progress. The Functional Independence Measure (FIM) score increased from 98 to 115, reflecting improved functional independence. These findings suggest that the combination of pulmonary and musculoskeletal physiotherapy effectively improved respiratory function, muscle strength, and the patient’s overall functional capacity.

The development of discipline in children should begin at an early age, particularly in managing time for studying, playing, worship, and resting. Simple time management assistance activities are conducted to help children understand the importance of time regulation and to foster disciplined behavior in their daily activities. These activities include introduction sessions, material delivery, question-and-answer sessions, as well as the distribution of gifts and group photo sessions, all carried out in an interactive and participatory manner. The results indicate that children begin to organize their daily schedules, follow instructions, and demonstrate gradual improvements in discipline. The research method used is Participatory Action Research (PAR), which actively involves children, facilitators, and teachers/ustadzah in the stages of planning, implementation, observation, and reflection. This approach enables children to learn by doing, fostering a sense of responsibility, critical thinking skills, and the development of positive habits in a sustainable manner. The activity is also supported by the active participation of teachers/ustadzah and the facilitation team to enhance the effectiveness of the learning process; therefore, simple time management assistance based on the PAR method is effective in fostering discipline and orderliness in children from an early age.

Floods are the most frequent hydrometeorological disasters in Indonesia and significantly contribute to increased trauma cases and disruption of healthcare services, particularly in vulnerable regions such as Aceh Province. These conditions are exacerbated by limited resources, damaged health facilities, and restricted access to referral centers. This study aims to examine the implementation of early emergency surgical management during flood disasters based on damage control surgery principles and international guidelines. A descriptive qualitative approach was employed through a literature review combined with field observations conducted during the emergency response phase of flood disasters in Bireuen Regency. Data were collected from direct clinical observations, brief interviews with healthcare providers, and documentation of trauma cases requiring early surgical intervention. The results indicate that effective patient stabilization can be achieved despite limited resources through airway, breathing, and circulation (ABC) management, hemorrhage control, wound irrigation, and fracture immobilization using simple and improvised equipment. Approximately 90% of patients were successfully stabilized prior to referral to definitive healthcare facilities. In conclusion, adaptive and timely application of damage control surgery principles plays a crucial role in saving lives and strengthening emergency surgical response during flood disasters.

Urban development has resulted in an increase in impermeable surfaces, increasing the risk of runoff inundating the road network. This situation occurs in the drainage system on Jl. Letjend S. Parman, Jl. Emo Kurniaatmaja, and Jl. Pulau Banda, Pasirkareumbi Village, Subang Regency. This study aims to evaluate the hydraulic performance of existing channels and develop redesign guidelines to reduce the risk of local flooding. The methods used include hydrological analysis of daily maximum rainfall data from the Subang rainfall station, rainfall frequency analysis using the Generalized Extreme Value (GEV) distribution, Intensity-Duration-Frequency (IDF) curves, and hydrological and hydraulic simulations using the Storm Water Management Model (SWMM). Model parameters include sub catchment area, rainfall intensity, time of concentration, infiltration using the Curve Number method, channel dimensions, cross-sectional shape, channel material, and the Manning coefficient. The results indicate that the GEV distribution provides a good fit for determining design rainfall. Based on the typology of a metropolitan city and a catchment area of ​​26.04 ha, the modeling period is 2 to 5 years. The SWMM simulation results indicate that some channel segments have very high flow velocities, potentially causing scour, while other segments have very low velocities, potentially causing sedimentation. This confirms the need for evaluation and restructuring of channel dimensions and slopes to improve the hydraulic performance of road drainage and reduce localized flooding.

Childbirth is the time after labor to restore health again which takes 6-12 weeks. Giving Moringa and banana heart aims to increase the milk production. The result of a survey conducted on 15 postpartum,obtained the result of 9 people (64,28 %) experienced less milk production. The purpose of this study is to analyze the effect of Moringa leaf and banana heart on the increase of milk production in postpartum in  Nunkurus Village, East Kupang District, Kupang Regency. This research is pre experimental research. The population in this study were all postpartum in the work area of Nunkurus Village, East Kupang District, Kupang Regency.Sample size is 15 people obtained from purposive sampling technique. The result of the study were analyzed using the Wilcoxon statistical test. The result of the research showed that before the leaves were given moringa leaf and the banana heart mostly (73,3%) had milk production not smoothly and after given moringa leaf and banana heart almost whole (86,7%) experienced milk production smoothly. Based on Wilcoxon test result show data that the value of ρ = 0,003 and value a = 0,05  can be said that ρ-value <a. So H0 rejected and H1 accepted which means there is an influence of Moringa leaf and banana heart to increase milk production in postpartum mothers in Nunkurus Village, East Kupang District, Kupang Regency. It is Expected that the results of this study can provide information about the benefits of Moringa leaf and banana heart to increase milk production in postpartum in the working area of Nunkurus Village, East Kupang District, Kupang Regency.

Background: Zinc Oxide Eugenol (ZOE) is the most widely used root canal filling material in primary teeth. Its sedative effect on the pulp and its ability to effectively seal the root canal contribute to the success of pulpectomy procedures. One of the main advantages of ZOE is its slow resorption rate, which allows it to maintain its integrity over time while the primary tooth remains functional. Purpose: ZOE is used to treat reversible pulpitis. Case: An 8-year-old boy came to Soelastri Dental and Oral Hospital complaining of a cavity in his lower left molar that was sensitive to cold. Case Management: The results of clinical and radiographic examinations indicated that the treatment performed in this case was a pulpotomy using ZOE material and a final restoration with SSC. Conclusion: The pulpotomy treatment was evaluated successfully, and the tooth was restored with a stainless steel crown.

The increasing use of electronic devices, specifically gadgets, among elementary school children has caused various problems, such as addiction, decreased social interaction, health problems, and decreased concentration in learning. These problems involve not only children but also objects and things around them, as well as parents in managing them. Gadget use is not just a matter of quantity that exacerbates this condition. As a solution, the community service team held a socialization focused on improving healthy digital literacy through counseling, interactive discussions, and practical simulations. Results achieved included increased knowledge about the risks of excessive gadget use, increased collective awareness in limiting usage time, and the formation of practical guidelines for healthy gadget use in school and family environments. The results of the activity were documented in the form of a scientific article published in the community service journal as an academic contribution. Overall, the activity has gone according to plan in terms of planning, implementation, and partner involvement. Active participation of participants was evident in the enthusiasm in the discussions and the school's commitment to continuously monitoring gadget use. Thus, this program is expected to have a long-term positive impact in shaping wise behavior in using technology among elementary school children.

Closed distal humerus fractures are injuries involving the distal portion of the humeral bone without disruption of the overlying skin, most commonly resulting from direct trauma such as the impact of a heavy object or blunt force to the elbow region. Although relatively uncommon in adults, this type of fracture presents considerable complexity due to its proximity to neurovascular structures and the elbow joint. Diagnosis is established through targeted anamnesis, comprehensive physical examination, and radiographic imaging in two standard projections to assess the location, fracture pattern, and degree of displacement. Additional modalities such as computed tomography (CT) may be indicated in cases of articular or comminuted fractures to enhance operative planning. Management depends on fracture stability, the extent of displacement, and the condition of surrounding soft tissues. In unstable or comminuted fractures, operative intervention such as Open Reduction and Internal Fixation (ORIF) is the preferred approach to restore bony continuity, reconstruct articular anatomy, and enable early mobilization. The primary therapeutic goals are to optimize elbow function, maintain joint stability, and prevent long-term complications including stiffness, malunion, delayed union, or non-union. Postoperative rehabilitation plays a crucial role in preventing restricted range of motion and restoring extremity strength. This case report describes a 49-year-old male with a comminuted closed distal humerus fracture of the left arm following direct trauma from a heavy object. The patient underwent complete clinical and radiological evaluation and was treated with ORIF. Early outcomes demonstrated adequate restoration of stability and alignment, affirming that accurate diagnostic assessment and timely intervention significantly contribute to optimal functional recovery of the affected extremity.

This community service program was implemented to strengthen the capacity of the SIJATI Business Group in managing oyster mushroom cultivation in Sait Buttu Saribu Village, Simalungun Regency. This activity was motivated by the group's great potential in oyster mushroom production, but still faces obstacles in production, marketing, and business management aspects. The method used was a participatory-collaborative approach through stages of socialization, training, mentoring, provision of modern production equipment, strengthening digital marketing, and business management coaching. The results of the activity showed a significant increase in the group's capacity. From a production aspect, the use of a stainless steel steamer machine and modern baglog racks increased time efficiency, saved energy, and doubled production capacity. From a marketing aspect, digital marketing training and collaboration with students as resellers expanded market reach, increased consumer interaction, and drove increased turnover. From a management aspect, digital-based financial records and assistance with business legality strengthened institutions and opened opportunities for access to capital. This program also had a social impact by increasing the economic contribution of housewives who were members of the group, thereby contributing to the welfare of the village community. Overall, strengthening the capacity of the SIJATI group aligns with achieving the Sustainable Development Goals (SDGs), particularly in poverty alleviation, gender equality, and inclusive economic growth. Therefore, this activity can serve as a model for empowering competitive and sustainable local commodity-based MSMEs.

Intensive social media use has become an ingrained phenomenon in the daily lives of college students. Technological developments and high accessibility to digital platforms cause students to spend a significant amount of time interacting virtually. This condition has various psychological implications, one of which is increased anxiety levels. This study aims to determine the relationship between the intensity of social media use and anxiety levels in college students. The method used was a quantitative approach with a correlational design through a survey distributed to a number of student respondents from various study programs. The research instruments included a questionnaire regarding the frequency of social media use and a validated anxiety scale. The results showed a significant relationship between the intensity of social media use and students' anxiety levels. The higher the frequency of social media use, the greater the tendency for students to experience anxiety. Several factors that trigger anxiety include social comparison with other users, the need for validation through the number of "likes" and comments, and the pressure to project an ideal self-image online. Furthermore, most students expressed feelings of anxiety or restlessness when not accessing social media for a certain period of time, indicating psychological dependence. These findings indicate that social media has a significant influence on students' psychological conditions, particularly in triggering anxiety. Therefore, it is crucial for higher education institutions, educators, and parents to provide education on healthy and balanced social media use. Preventive and promotive interventions to support student mental health are essential to mitigate the negative impacts of social media and foster wiser digital behavior in today's technological era.

Motor development in infants is a crucial process that occurs gradually and follows the principles of age-appropriate development. Each fundamental motor stage—such as tummy time, rolling over, sitting, crawling, standing, and walking—must be passed through sequentially to ensure optimal motor concept development. Skipping or insufficient stimulation of these stages may lead to difficulties in understanding functional body movements. One of the main causes of delayed motor development includes a lack of motor stimulation time, overly restrictive parental supervision, and low levels of motivation and stimulation provided to the child. Tummy time, or placing the baby in a prone position while awake, is a proven effective form of motor stimulation that supports the development of the baby’s neck, back, and arm muscles. This activity also assists infants in reaching subsequent developmental milestones such as rolling over and crawling. This Community Service Program (PkM) was conducted at the Physioroom Clinic and was attended by 15 mothers with infants aged 3 to 6 months. The objective of the program was to enhance mothers’ knowledge regarding the importance of tummy time in supporting infant motor development. The program's implementation included educational sessions, tummy time practice demonstrations, group discussions, and interactive Q&A sessions. To measure the increase in participant knowledge, a pre-test and post-test were administered before and after the activity.The results of this PkM activity showed an increase in the average knowledge score from 6.4 in the pre-test to 8.6 in the post-test. This improvement demonstrates the program’s effectiveness in educating mothers about the benefits of tummy time for infant motor development. It is hoped that the mothers will consistently apply this stimulation at home to optimally support their children's growth and development.

The increasing use of gadgets among medical students raises concerns about the health impacts, especially on sleep quality and eye health. Medical students have a high intensity of digital device use due to academic demands, which has the potential to cause excessive exposure to blue light (blue light), sleep disturbances, and eye fatigue (eye strain). This study aims to explore the relationship between the duration of gadget use with sleep quality and eye strain in medical students and to understand the factors that strengthen or weaken its impact. The research method used is qualitative descriptive based on a literature study by reviewing literature from scientific journals, books, and relevant documents. The results of the study showed that exposure to blue light can reduce melatonin production, disrupt circadian rhythms, and cause sleep disorders such as insomnia. In addition, long-term use of gadgets without sufficient rest increases the risk of digital eye strain, characterized by symptoms such as dry eyes, blurring, pain, and headaches. Medical students who are susceptible to intensive exposure to digital screens are at higher risk of this disorder. In conclusion, there is a strong interconnection between gadget use, sleep quality, and eye fatigue. Preventive efforts such as screen time management, use of blue light filters, and education about healthy visual habits are important to maintain the health and productivity of medical students.

Aging is a dominant risk factor for most forms of cardiovascular disease. Sedentary lifestyle in elderly with obesity can decrease the function of cardiovascular system. Previous study determined that moderate intensity aerobic exercise was highly recommended in elderly because the type of exercise can improve body fitness and oxidative damage due to aging. The aims of this study was to investigate the effect of moderate intensity aerobic exercise on NOx plasma level, systolic blood pressure (SBP) and diastolic blood pressure (DBP) in sedentary elderly women with overweight. The research method is quasi experimental with pre test and post test design. The sample included 33 volunteer sedentary elderly women overweight with age 65,11±4,85 years old that divided on two group that is the experimental group (EG/ n=17) and control group (CG/ n=16). EG performed moderate intensity aerobic exercise (walking) during 30 min per session, intensity 50–80% heart rate maximum,  three times per week for 12 week. The examination of NOx plasma level by ELISA method and resting blood pressure by auscultation method. Data was processed by unpaired t-test. Experimental group had significantly lower level of SBP (-10,294 p 0,001) than CG. NOx plasma level showed significantly decreases in both group (p < 0,05), but the decreasing trend was found to be higher in the CG. DBP and body mass index (BMI) did not change (p >0,05). Moderate intensity aerobic exercise can delay the reduction of NO due to aging proceses.

Hospitalization is a disruptive experience for children that can also induce anxiety. Generally, the reactions of children undergoing inpatient care are anxiety, crying, and restlessness. Play therapy can help distract children from pain and provide relaxation. This study aims to determine the effect of squishy toy play therapy on reducing anxiety in preschool-aged children (3-6 years old) undergoing hospitalization. This study employs a Pre-Experimental method with a One Group Pre-Post Test Design. The population for this research is 200 children each month. The sample consists of 80 respondents who are preschool-aged (3-6 years old) and have been admitted to Rizani Paiton Probolinggo Hospital. The sampling technique used is accidental sampling. Data management involves processes such as Editing, Coding, Scoring, and Tabulating, and the data are analyzed using the Wilcoxon test.Top of FormBottom of Form The results of this study show that the average anxiety score before the squishy toy play therapy was 2.54. The average anxiety score after the therapy was 1.56. The analysis using the Wilcoxon test indicates that there is an effect of squishy toy play therapy on reducing anxiety in preschool-aged children (3-6 years old) undergoing hospitalization, with a p-value of 0.000. Squishy play therapy is carried out twice a day for three consecutive days, squishy play therapy is suitable for preschool children because this therapy is easy to do, does not require a lot of facilities and takes a short time. Suggestions for further researchers observe parents and closest people as one of the factors that influence the effectiveness of squishy play therapy.

Breadfruit (Artocarpus altilis) is a kind of consumable plant, generally peoples will process the fruit and discharge the peel. Effervescent granule is a practice of powder preparation. This study aim to create the effervescent granulation preparation to making the peel if breadfruit will easier to consumen with extract concentrations : F1 (5%), F2 (10%), and F3 (15%) and determine the characteristics of the resulting preparation. Making effervescent granules using the alkaline granulation method. Then the resulting preparation is evaluated by testing, including organoleptic test, pH, flow rate, angle of repose, dissolve time, water content, granule size distribution, and froth height. Breadfruit peel extract can be formulated into effervescent granule preparations. Effervescent granules of F1, F2, and F3 from breadfruit peel extract produce a brownish-white powder, characteristic of the extract. All of the formulas have qualified pH, water content, rest angle, dissolve time, and granule size. Flow velocity F1 7.99 g/sec and F2 7.21 g/sec, including flow velocity "good,” while F3 includes “poorly soluble’ 2.68 g/sec. However, the formulas do not meet the foam height requirements in the market with a foam height of 3 cm, where FI is 0.9 cm, F2 is 0.93 cm, and F3 is 0.96 cm.    

Electronic Health Records (EHRs) have become an important component in the digital transformation of the healthcare system in Indonesia. However, EHR implementation in many health facilities in Indonesia is still fragmentary and not fully integrated. The main challenges in integrating health data into the national health system are issues of interoperability, data security, and inter-institutional coordination. This study aims to identify and analyze the main challenges in integrating health data from various EHR systems into Indonesia's national health system and its impact on the quality of health services, operational efficiency, and data security. The research method used was a descriptive qualitative approach, which combined literature study and in-depth interviews with experts in the field of health information technology and health policy. A literature study was conducted to identify technical, operational, and policy challenges faced in EHR implementation in Indonesia. Expert interviews were used to validate the findings obtained from the literature and provide additional insights into the local context. Thematic analysis techniques were used to organize and interpret the data. The results showed that the lack of common data standards is a major obstacle in the integration of EHR systems in Indonesia.A total of 45% of healthcare facilities adopt HL7 standards, 30% adopt FHIR, and 25% use proprietary systems, leading to the inability to efficiently share data between institutions. In addition, data security issues are also a major concern, with many healthcare facilities yet to implement adequate security protocols. Limited coordination between health institutions also hinders wider integration. Nonetheless, EHR integration has the potential to improve operational efficiency, with up to 25% reduction in administrative time in institutions that have integrated their systems.

Physiotherapy is a form of health service aimed at individuals and communities. The scope of physiotherapy services is to develop, maintain, and restore movement and body function throughout the life span. This service can be done through a promotive, preventive, curative, and rehabilitation approach. One of the many cases of physiotherapy is musculoskeletal complaints. Musculoskeletal complaints can occur due to habits carried out during work. If the body position is not correct and maintained for a long duration, it can trigger the emergence of musculoskeletal complaints. Work that lasts for a long time will decrease a person's body ability and can cause complaints and disorders in the body, especially musculo problems, one of which is neck pain. Neck pain is a multifactorial disease and is a major problem in society today. Some risk factors for neck pain, such as old age, female gender, low social support, and non-ergonomic work postures. The method of community physiotherapy activities used is to provide health promotion counseling and education regarding physiotherapy management in the form of stretching that can be done independently. The media used are leaflets and posters. The purpose of this counseling is to provide education and physiotherapy treatment related to neck pain in Keripik Tempe Sanan workers so that they can improve the complaints that have been felt and minimize the occurrence of injuries.

Physiotherapy is a form of health service aimed at individuals and communities. The scope of physiotherapy services is to develop, maintain, and restore movement and body function throughout the life span. This service can be done through a promotive, preventive, curative, and rehabilitation approach. One of the many cases of physiotherapy is musculoskeletal complaints. Musculoskeletal complaints can occur due to habits carried out during work. If the body position is not correct and maintained for a long duration, it can trigger the emergence of musculoskeletal complaints. Work that lasts for a long time will decrease a person's body ability and can cause complaints and disorders in the body, especially musculo problems, one of which is neck pain. Neck pain is a multifactorial disease and is a major problem in society today. Some risk factors for neck pain, such as old age, female gender, low social support, and non-ergonomic work postures. The method of community physiotherapy activities used is to provide health promotion counseling and education regarding physiotherapy management in the form of stretching that can be done independently. The media used are leaflets and posters. The purpose of this counseling is to provide education and physiotherapy treatment related to neck pain in Keripik Tempe Sanan workers so that they can improve the complaints that have been felt and minimize the occurrence of injuries.

How Cola nitida could affect the urine calcium and magnesium concentrations of the male human subjects in comparison to the female counterpart were focused on. Sixty subjects (males=30 and females=30) and unaccustomed to Cola nut eating were involved. Their age range was between 18 and 28years. Three (3) sub-categories were involved: underweight=10, normal weight=10 and overweight=10. Hypertensive, renal and any subject with cardio-pulmonary-related conditions were exempted from the study. The normal chamber temperature, (RT=270C and RH=70%), the raised chamber temperature (RT =370C and RH=90%) were studied. Sequel to the foregoing, the subjects sat quietly in the sweat chamber for 20 minutes. The third experimental condition was the normal chamber temperature with exercise (RT=270C and RH=70%) and the subjects rode a bicycle ergometer at 750J/minute for 20 minutes. All of these happened prior to the consumption Cola nitida. Ahead of the experimentation in the sweat chamber, the subject urinated in a container in order for the timed urine volume to be measured and urine was again taken at the end of the experimentation that was also measured in order to obtain the actual urine volume within the given period. Thereafter, the urinary flow rate was calculated. The urine calcium and magnesium concentrations were likewise estimated. 0.5g/kg body weight of Cola nitida was given to each subject and chewed as a bolus. After swallowing, 50ml of deionized water was given to each subject to drink and the subject was allowed to rest for 90 minutes before being brought into the sweat chamber. The results showed that in respect to urine Ca ions concentration, no significant change was observed in a comparison between the males and females after the ingestion of Cola nitida under normal, raised temperature and exercise experimental conditions. As regards urine Mg ions concentration, no significant change was observed in a comparison between the males and females after the ingestion of Cola nitida under normal and exercise experimental conditions. However, there was a significant increase in Mg ions concentration in the female UW and NW subjects compared to the males after the consumption of Cola nitida under raised temperature condition.

Elderly is the final stage of adulthood where a person will enter the age of 60 and above. In the elderly, osteoarthritis occurs more often in the knee joints (knee osteoarthritis) than in other areas, such as the joints of the hands and hips. The most common clinical symptoms are pain that arises gradually and worsens over time, stiffness, crepitus, and joint motion restrictions. The purpose of this study was to educate the elderly about the meaning of knee osteoarthritis, risk factors, signs and symptoms, prevention efforts, and exercises that can be done at home. The method used was to provide counseling in the form of health promotion about knee osteoarthritis to the elderly with leaflets as a medium for counseling. Pre-test and post-test were given to measure the effectiveness of counseling. The conclusion of this study was that the activity went smoothly, was well realized, and received enthusiasm from the participants. The results obtained based on the evaluation were an increase in the knowledge and understanding of the elderly community in Tulusrejo Village regarding knee osteoarthritis.