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Personal hygiene practices during menstruation is important to maintaining the reproductive health of adolescent girls and preventing reproductive organ infections. Poor hygiene causes post-menstrual problems in 5.2 million adolescents in Indonesia, such as reproductive tract infections, urinary tract infections, pathological vaginal discharge, fungal infections, genital area irritation, and unpleasant odor. Factors influencing personal hygiene practices during menstruation include knowledge, perceptions, attitudes, and infrastructure. This study was aimed determine the relationship between knowledge, perceptions, attitudes, and infrastructure and personal hygiene practices during menstruation among female students at the Daarussa'adah Qur'an Tahfidzil Islamic Boarding School in Pesawaran in 2026. This study was quantitative with a cross-sectional approach. The population was all female students at the Daarussa'adah Qur'an Tahfidzil Islamic Boarding School in Pesawaran, and a sample of 74 respondents was selected using total sampling. Data analysis used the chi-square test with a significance level of 95%. The results of the study showed a relationship between knowledge (p-value = <0.001; OR = 279.000), perception (p-value = <0.001; OR = 620.000), attitude (p-value = <0.001; OR = 165.333), and infrastructure (p-value = <0.001; OR = 0.002) and personal hygiene behavior during menstruation. Suggested for the Islamic boarding schools include routinely improving reproductive health education regarding personal hygiene during menstruation and providing adequate infrastructure to support the development of good knowledge, perceptions, and attitudes, so that female students can optimally implement personal hygiene behaviors during menstruation.

Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels due to insufficient insulin production or ineffective insulin utilization. The prevalence of DM in Indonesia reached 11.7% in the 2023 National Health Survey, with Brebes Regency recording 568 DM cases in 2025 and increasing to 157 cases in Tonjong Village in January 2026. This case study aims to describe comprehensive nursing care for Ny. M, a 52-year-old patient diagnosed with endocrine system disorder (diabetes mellitus), in the family of Tn. I at Karang Anyar Village, Tonjong District, Brebes Regency. The method used was a case study with data collection through interview, observation, physical examination, blood glucose measurement, and literature review conducted on December 26–28, 2025. The assessment found subjective data: the patient frequently felt fatigue, tingling in both legs, excessive thirst, and increased urination frequency. Objective data: pale and fatigued face, blood pressure 150/100 mmHg, pulse 95x/min, respiration 22x/min, temperature 36.7°C, and random blood glucose (RBG) 155 mg/dl. Two nursing diagnoses were established: blood glucose instability and readiness for enhanced knowledge. Interventions implemented included hyperglycemia management (monitoring blood glucose, dietary education, complementary herbal therapy with ginger and honey), and health education regarding DM complications. Evaluation results showed that after 2 days of nursing visits, fatigue decreased, blood glucose improved (RBG 130 mg/dl), and the patient's knowledge about DM complications was resolved.

Type II Diabetes Mellitus is a chronic metabolic disorder commonly found in the elderly due to insulin resistance and impaired pancreatic hormone secretion. This condition leads to elevated blood glucose levels, physical weakness, and decreased daily activity performance, which ultimately reduces quality of life. Blood glucose control can be achieved not only through pharmacological therapy but also by applying non-pharmacological approaches such as progressive muscle relaxation therapy. This study aims to determine the effect of progressive muscle relaxation therapy on blood glucose levels in elderly patients with Type II Diabetes Mellitus. This research employed a case study method involving Mrs. A, an elderly patient experiencing hyperglycemia with a fasting blood glucose level of 247 mg/dl. The intervention was carried out over three consecutive days, consisting of progressive muscle relaxation exercises for 15–20 minutes per session, accompanied by dietary education, light physical exercise, and fall prevention guidance. Data were collected through observation, interviews, and blood glucose measurements before and after the intervention. The results showed a decrease in blood glucose level from 215 mg/dl to 158 mg/dl after three therapy sessions. The patient appeared more relaxed, experienced reduced fatigue, improved sleep quality, and demonstrated better urinary control. Conclusion: progressive muscle relaxation therapy is effective in lowering blood glucose levels and improving both physical and psychological conditions in elderly patients with Type II Diabetes Mellitus.

Benzena (C6H6) termasuk senyawa hidrokarbon aromatik yang bersifat mudah menguap dan larut, serta memiliki beberapa turunan, di antaranya etilbenzena, kumena, anilin, klorobenzena, dan sikloheksana. Tingkat paparan benzena pada manusia dapat diketahui melalui biomarker fenol dalam urine dengan ambang normal menurut WHO yaitu kurang dari 25 mg/L. Penelitian ini dilakukan untuk menggambarkan kadar fenol urine, penggunaan alat pelindung diri (APD), lama kerja, serta keluhan kesehatan pada pekerja SPBU di Kota Kendari tahun 2026. Metode yang digunakan adalah penelitian observasional deskriptif dengan pendekatan cross-sectional. Sebanyak 32 responden dipilih menggunakan teknik accidental sampling, Data penelitian diolah dengan analisis univariat untuk melihat distribusi frekuensi tiap variabel. Hasilnya, 6 responden (18,8%) punya kadar fenol urine >19 mg/L. Sementara itu, semua responden (100%) bekerja maksimal 8 jam/hari. Selain itu, mayoritas pekerja masih kurang patuh dalam penggunaan APD, yaitu sebanyak 21 responden (65,6%). Keluhan kesehatan yang paling sering dirasakan adalah mata perih, berair, atau terasa terbakar yang dialami oleh 22 responden (68,8%). Berdasarkan hasil tersebut, dapat disimpulkan bahwa pekerja SPBU masih berisiko mengalami paparan benzena yang terlihat dari adanya kadar fenol urine tidak normal, rendahnya kepatuhan penggunaan APD, serta munculnya berbagai keluhan kesehatan walaupun durasi kerja masih berada dalam batas normal.

Decline in the ability to perform activities of daily living among older adults can lead to poor personal hygiene practices, thereby increasing the risk of infections, including urinary tract infections. This study aims to analyze the effect of improving self-care in personal hygiene on reducing the risk of urinary tract infections in the elderly.The method used was a case study involving a single respondent (Mr. W), with a four-week intervention consisting of one visit per week, each lasting approximately 45 minutes. The intervention included personal hygiene education, practical demonstrations, direct assistance, and environmental modification.The results showed an improvement in both awareness and personal hygiene practices, as indicated by the ability to brush teeth regularly, perform proper genital care after urination, and maintain consistency in changing clothes and underwear, although some habits still required ongoing assistance.In conclusion, a holistic approach through education, assistance, and environmental support is effective in gradually improving personal hygiene practices among older adults. However, continuous efforts are necessary to achieve long-term behavioral consistency.

Decline in the ability to perform activities of daily living among older adults can lead to poor personal hygiene practices, thereby increasing the risk of infections, including urinary tract infections. This study aims to analyze the effect of improving self-care in personal hygiene on reducing the risk of urinary tract infections in the elderly.The method used was a case study involving a single respondent (Mr. W), with a four-week intervention consisting of one visit per week, each lasting approximately 45 minutes. The intervention included personal hygiene education, practical demonstrations, direct assistance, and environmental modification.The results showed an improvement in both awareness and personal hygiene practices, as indicated by the ability to brush teeth regularly, perform proper genital care after urination, and maintain consistency in changing clothes and underwear, although some habits still required ongoing assistance.In conclusion, a holistic approach through education, assistance, and environmental support is effective in gradually improving personal hygiene practices among older adults. However, continuous efforts are necessary to achieve long-term behavioral consistency.

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.

According to the American Diabetes Association (ADA), diabetes mellitus is a chronic and complex disease that requires ongoing management and various strategies to control blood sugar levels and reduce associated risks. Patient Mrs. J, a 52-year-old woman and farmer, presented with complaints of numbness and tingling in both legs that began approximately 2 months prior to her current visit and had worsened over the past week. The symptoms felt like being pricked and sometimes felt hot, especially at night, thereby interfering with daily activities. The symptoms were accompanied by frequent urination, especially at night, frequent thirst, frequent hunger, a feeling of weakness, and intermittent blurred vision. The patient had been diagnosed with diabetes mellitus approximately 5 years ago but did not consistently take medication (glimepiride). The patient still frequently consumes sweet, coconut-based, and fried foods. Physical examination revealed reduced sensation in the lower extremities. Laboratory tests showed elevated blood sugar levels. Based on the medical history, physical examination, and supporting tests, the patient was diagnosed with Type 2 Diabetes Mellitus. The patient was advised to record test results and changes in his health status in a health record book, and to involve family members in supporting treatment adherence and a healthy lifestyle. The patient works as a farmer with an irregular income, depending on the harvest. Daily expenses are shared with his son, so his economic condition

This study was conducted at PT. Asmin Bara Bronang, Sepan Uring Village, Kapuas Tengah District, Kapuas Regency, Central Kalimantan Province, with the aim of analyzing the productivity and influencing factors of the PC 300 excavator in coal getting activities to support the achievement of production targets. The objective of this research is to analyze the actual productivity and the factors affecting it in Sector 7 coal getting operations. The research method used field observation with a quantitative descriptive analysis approach. The results show that the productivity of the PC 300 excavator ranges from 127.12 to 224.29 tons/hour, with an average of 173.98 tons/hour. In several conditions, the productivity is still below the company’s target of 180 tons/hour. The analysis indicates that productivity is influenced by material conditions, particularly the Hardgrove Grindability Index (HGI) value of 47, which reflects relatively harder material with coarser particle size, and a moisture content of 22.71%, causing the material to be sticky and cohesive, thereby affecting the bucket filling process. In addition, operational factors such as bottom loading patterns, limited number of tailgate dump trucks, and suboptimal selection of dump truck types also contribute to productivity performance.  Based on the findings, it can be concluded that the productivity of the PC 300 excavator has not consistently met the company’s target. Therefore, improvement efforts are required, including the implementation of top loading methods, increasing the number of tailgate dump trucks, optimizing the selection of hauling equipment, and controlling material conditions that affect the digging process.    

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).

Background: The management of hemorrhagic shock in obstetrics typically involves aggressive fluid resuscitation, often leading to iatrogenic fluid overload and pulmonary edema. Implementing a timely fluid de-escalation (deresuscitation) strategy is critical to facilitate ventilator weaning and achieve early extubation. Case Illustration: A 31-year-old female (G5P3A1) was admitted to the ICU following emergency Re-Cesarean Section due to Grade IV hemorrhagic shock caused by postpartum hemorrhage (PPH) and placenta previa totalis. Intraoperative aggressive resuscitation triggered iatrogenic fluid overload, manifesting as bilateral pulmonary edema and severe gas exchange impairment (initial AaDO2 of 459 mmHg and lactate level of 2.8 mmol/L). Management and Results: Following initial hemodynamic stabilization, an active fluid de-escalation strategy was initiated on Post-Operative Day 1 (POD 1) using continuous furosemide infusion at 10 mg/hour targeting a negative fluid balance. The patient achieved a negative fluid balance of -1485 mL within 24 hours, accompanied by a significant increase in urine output (7.8 mL/kg/hour). This approach successfully reduced the AaDO2 to 162 mmHg and improved lactate clearance to 1.8 mmol/L without compromising hemodynamic stability. The patient was successfully extubated within 18 hours of ICU admission. Conclusion: Early transition from resuscitation to fluid de-escalation, guided by perfusion targets (lactate) and oxygenation markers (AaDO2), is safe in critical obstetric cases. This strategy effectively resolves pulmonary edema and accelerates early extubation.

Chronic Kidney Disease (CKD) is a structural or functional abnormality of the kidneys that lasts ≥3 months with the criteria of eGFR <60 mL/min/1.73 m² or the presence of kidney damage such as albuminuria and urinary abnormalities (Kidney International, 2024). CKD patients, especially those treated in intensive care units, often experience gastrointestinal disorders such as increased volume of gastric residues. Giving enteral nutrition to patients with NGT can increase the volume of gastric residue which is at risk of causing complications. One of the non-pharmacological interventions that can be carried out is abdominal massage, which is a light massage technique in the abdominal area that can stimulate intestinal peristalsis and improve gastrointestinal motility. The purpose of this case study was to determine the effect of  giving abdominal massage on reducing the volume of gastric residue in CKD patients in the ICU. This scientific paper uses a case study design using abdominal mass therapy. The number of respondents was 3 people, the intervention was carried out for 3 days with a time of 10-15 minutes. The application of abdominal massage therapy in the three respondents showed a decrease in the volume of gastric residue after admixture was carried out  for three consecutive days with an average decrease in the volume of gastric residue, which was 50 cc - 75 cc. Abdominal massage is a safe and effective nonpharmacological nursing intervention to help reduce gastric residue volume and support enteral nutrient tolerance in CKD patients in the ICU.

Typhoid fever is an infectious disease caused by Salmonella typhi. Transmission can occur through air or food contaminated with the urine and feces of typhoid sufferers, such as air used for drinking, cooking, and washing food. Symptoms of typhoid fever include a prolonged high fever, defined as an elevated body temperature of >37.5°C. Other symptoms can include fatigue, nausea, abdominal pain, constipation or diarrhea, and headache. This study aimed to treat children with typhoid fever. The method used was a case study of a five-year-old child with typhoid fever who was hospitalized for four days. The results showed that the child had fever, obesity, and decreased appetite. The child's problem was hypothermia, while cooling interventions were used to manage hypothermia, and one of the cooling procedures performed was the application of aloe vera compresses. The evaluation results showed that the hyperthermia resolved after four days of hospitalization. Based on this study, it is hoped that patients and their families can independently apply aloe vera compresses to treat hypothermia in children.

Diuretic resistance is a serious complication in heart failure patients associated with increased morbidity and mortality. Tolvaptan, a vasopressin V2 receptor antagonist, offers an alternative therapeutic mechanism through aquaresis. This study aims to evaluate the effectiveness and safety of tolvaptan in heart failure patients with diuretic resistance. A retrospective cohort study was conducted on 58 hospitalized patients with NYHA III-IV heart failure and diuretic resistance (urine output <1000 mL/day despite furosemide use ≥80 mg/day) who received tolvaptan 7.5-15 mg/day for 7 days. Variables measured included weight change, urine output, serum sodium, and kidney function. The results showed a significant increase in daily urine output from 820±230 mL to 2180±520 mL (p<0.001), along with an average weight loss of 3.4±1.1 kg (p<0.001). Hypernatremia (>145 mEq/L) occurred in 8.6% of patients. In conclusion, tolvaptan is effective in improving diuresis and reducing congestion in heart failure patients with diuretic resistance, although the risk of hypernatremia should be monitored.

Urinary tract infection (UTI) is a common bacterial infection that requires appropriate antibiotic management to prevent complications and antimicrobial resistance. Ceftriaxone and ciprofloxacin are commonly used antibiotics with different clinical indications in UTI treatment. This literature review aims to compare the role of ceftriaxone and ciprofloxacin in the management of urinary tract infections. A narrative literature review was conducted using articles published within the last ten years from PubMed, ScienceDirect, and Google Scholar databases. The review focuses on clinical effectiveness, resistance patterns, and therapeutic considerations. The findings indicate that ceftriaxone is primarily used in moderate to severe or complicated UTIs, particularly in hospitalized patients, whereas ciprofloxacin is more frequently used in uncomplicated UTIs in outpatient settings. However, increasing bacterial resistance and safety concerns limit the empirical use of ciprofloxacin. These findings emphasize the importance of rational antibiotic selection based on clinical conditions and local resistance patterns.  

The prevalence of correct handwashing behavior with soap in Aceh Province is 36%. School-age children are the time to instill PHBS values ​​and have the potential to be agents of change to promote PHBS both in the school environment, family, and society. The impact of lazy handwashing with soap can cause various diseases such as diarrhea, flu, hepatitis A, and impetigo (a contagious infection that usually occurs in children who rarely wash their hands, this disease is characterized by red skin which then develops into small blisters). The purpose of this study is to determine the effectiveness of mini posters as a health promotion media on handwashing behavior with soap in elementary school students. The research method is one group pretest posttest design. The sampling technique is total sampling, while the number of samples in this study was 80 students from grades 5 and 6 of elementary school. The results of the study obtained before the intervention of mini posters washing hands with soap behavior of elementary school students 77.5% of students did not wash their hands with soap after urinating and defecating. After the intervention of mini posters washing hands with soap behavior of elementary school students 87.5% did wash their hands with soap. There is an effect of mini poster intervention on increasing handwashing behavior in elementary school students with a p value of 0.000 < 0.05. The results show that mini posters are a reference for the effectiveness of health promotion in preventing infectious diseases in elementary school children by implementing a handwashing program with soap in the school environment

Penyakit Ginjal Kronis (PGK) merupakan salah satu masalah kesehatan yang kritis karena bersifat progresif dan sering tidak menunjukkan gejala pada tahap awal, sehingga banyak pasien terdiagnosis pada stadium lanjut. Di Kota Jayapura, jumlah kasus PGK terus meningkat akibat hipertensi, diabetes, serta keterbatasan akses layanan deteksi dini. Penelitian ini bertujuan membangun model prediksi PGK menggunakan algoritma Naïve Bayes serta menganalisis keterkaitan variabel klinis yang berpengaruh terhadap PGK pada pasien di Jayapura. Penelitian mengikuti kerangka kerja Cross-Industry Standard Process for Data Mining (CRISP-DM), meliputi pemahaman bisnis, pemahaman data, persiapan data, pemodelan, evaluasi, dan deployment. Dataset yang digunakan terdiri dari 500 data pasien dengan 13 atribut medis, termasuk tekanan darah, glukosa darah, kreatinin serum, hemoglobin, albumin, dan kondisi urin. Seluruh data telah melalui tahap pembersihan sebelum pemodelan sehingga tidak memerlukan preprocessing lanjutan. Pemodelan dilakukan menggunakan RapidMiner, dan algoritma Naïve Bayes menghasilkan akurasi sebesar 94.40% dengan nilai precision dan recall tinggi pada kedua kelas PGK dan non-PGK. Hasil ini menunjukkan bahwa Naïve Bayes efektif dalam mengidentifikasi pola PGK pada data klinis lokal. Kontribusi utama penelitian ini adalah pemanfaatan data nyata dari pasien Kota Jayapura, sehingga menghasilkan model prediksi yang relevan secara regional serta memberikan pemahaman baru mengenai faktor medis yang dominan. Implikasi penelitian ini mencakup potensi integrasi model ke dalam sistem pendukung keputusan klinis maupun aplikasi monitoring kesehatan untuk mendukung deteksi dini PGK dan meningkatkan kualitas layanan kesehatan.

Dengue Hemorrhagic Fever (DHF) is a life-threatening disease caused by the dengue virus, which consists of four serotypes: DEN-1, DEN-2, DEN-3, and DEN-4. Laboratory examinations supporting DHF diagnosis include complete blood count, urine analysis, serological tests, and viral identification using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Prevention efforts focus on eliminating Aedes aegypti mosquito larvae through the implementation of 3M Plus, as well as using mosquito bite prevention products such as aromatherapy candles that are simple and practical for community use. Mancasan Baki Village, Sukoharjo, has experienced a high incidence of dengue cases, including fatalities, highlighting the need for community education on the genetic characteristics and molecular diagnostics of the dengue virus and preventive measures using innovative products. Educational activities were conducted through community presentations and demonstrations on making aromatherapy candles. The effectiveness of the program was measured by comparing participants’ knowledge before and after the intervention. The average pretest score was 6.63, which increased to 8.89 in the posttest. Statistical analysis using a t-test showed a significant difference (p < 0.05). Participant satisfaction results indicated that 64.5% rated the program as good, 32.5% as very good, and 3% as fairly good.

Nicotine is the main chemical substance found in cigarettes and has toxic and addictive properties. Exposure to nicotine in active smokers can cause various health problems, including respiratory and cardiovascular disorders and dependence. The prevalence of active smokers in RT 08 RW 05, Duren Jaya Village, East Bekasi Subdistrict is quite high. However, data on nicotine levels in the bodies of active smokers remain very limited. This study aims to determine the nicotine levels in active smokers in Duren Jaya Village, RT 08 RW 05, Bekasi Timur District, using urine samples. The research method employs a descriptive design with a cross-sectional approach. Urine samples were collected from 30 male active smokers aged over 35 years who had smoked for at least 15 years. Nicotine levels were measured at the Jakarta Regional Health Laboratory using Gas Chromatography-Mass Spectrometry (GC-MS). Data were analyzed descriptively using SPSS version 22. The study included 30 male respondents (100%) with an average age of 41 years. The analysis results showed nicotine levels ranging from 59.908 ng/mLto 459.941 ng/mL, with the majority of respondents falling into the category of active smokers based on the biological threshold for nicotine levels. It can be concluded that the results obtained indicate that these levels correspond to active smokers using light tobacco.

Prelabor rupture of membranes (PROM) remains one of the most frequently encountered obstetric complications and continues to contribute substantially to maternal and neonatal morbidity and mortality. Numerous factors have been associated with PROM; however, the available evidence presents considerable variation, highlighting the need to re-evaluate these determinants using recent empirical findings. This review aims to identify and synthesize the principal factors influencing PROM based on ten studies published within the last five years. A systematic search was conducted across PubMed, Scopus, Web of Science, and Google Scholar using predefined keywords, followed by screening through established eligibility criteria. Relevant data from each study including study design, geographical setting, assessed risk factors, and statistical outcomes such as odds ratios or relative risks  were extracted and compared. The review indicates that reproductive and urinary tract infections, inadequate nutritional status, high-risk obstetric history, and short interpregnancy intervals consistently emerge as major determinants. Social factors and the quality of antenatal services were also shown to heighten the likelihood of PROM. Overall, the findings emphasize that PROM arises from a combination of medical and non-medical influences, reinforcing the need for preventive strategies that adopt a comprehensive and integrated approach.