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Allergic rhinitis (AR) is a chronic inflammatory disorder of the nasal mucosa mediated by immunoglobulin E (IgE) in response to allergen exposure. This condition has become a significant global health concern because of its increasing prevalence and substantial impact on quality of life, sleep, cognitive function, and work productivity. AR is also commonly associated with other atopic diseases, including asthma and atopic dermatitis. This article aims to review the current understanding of allergic rhinitis, focusing on epidemiology, pathophysiology, clinical manifestations, diagnostic approaches, and evidence-based management strategies. This study used a narrative literature review method by analyzing scientific articles, clinical guidelines, and peer-reviewed journals published between 2015 and 2025. Literature sources were obtained from PubMed, Google Scholar, and relevant medical databases using keywords related to allergic rhinitis, IgE, diagnosis, and immunotherapy. The findings indicate that allergic rhinitis involves complex immune mechanisms characterized by Th2 lymphocyte activation, IgE production, and inflammatory mediator release. Diagnosis is primarily established clinically and supported by allergy testing such as skin prick tests or serum-specific IgE measurement. Intranasal corticosteroids remain the first-line therapy for moderate to severe cases, while antihistamines and leukotriene receptor antagonists are used as adjunctive therapies. Allergen immunotherapy has shown effectiveness in modifying disease progression and improving long-term outcomes. In conclusion, allergic rhinitis is a manageable chronic disease that requires a comprehensive and individualized treatment approach involving environmental control, pharmacotherapy, and immunotherapy.

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.

Knee septic arthritis is an orthopedic emergency that requires prompt and appropriate management to prevent permanent joint damage and systemic complications. Inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used for diagnosis and monitoring of treatment response; however, their prognostic value after surgical debridement remains variable. This systematic review aimed to evaluate the role of ESR, CRP, and platelet count as prognostic indicators following irrigation and/or surgical debridement in patients with knee septic arthritis. A literature search was conducted in January using PubMed, Google Scholar, ScienceDirect, Wiley Online Library, SpringerLink, and Semantic Scholar, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) tools. Fifteen studies meeting the inclusion criteria were qualitatively analyzed. The findings indicate that elevated preoperative CRP levels and delayed postoperative CRP reduction are associated with unfavorable clinical outcomes, including failure of infection eradication and the need for repeat debridement. Although ESR is consistently elevated during the acute phase, its slower decline limits its short-term prognostic utility. Platelet count may increase as part of the systemic inflammatory response but shows inconsistent prognostic value.

Rheumatoid arthritis (RA) is a daily disease seen in rheumatology clinics. It predominantly involves the appendicular skeleton. The axial skeleton is mostly spared except for the cervical spine where instability can occur and can be carefully assessed with cervical spine radiographs in flexion and extension. Radiographs may show erosion at the C1-C2 level with destruction of the transverse ligament that can result in atlantoaxial subluxation. Diagnosis is based on clinical, laboratory, and radiographic findings. Conventional radiography has been the mainstay for diagnosis of joint damage and subsequent follow-up. Radiography can provide only indirect information on synovial inflammation, however, and the technique is insensitive to early bone damage. Hand radiographs are frequently ordered as the first imaging modality in the assessment of patients presenting with peripheral arthritis. They can provide invaluable information about the bones, joints, mineralization, soft tissues and the distribution of abnormalities. Given the wide spectrum of rheumatic diseases, it might be challenging to make the diagnosis solely based on the clinical findings and imaging plays an important role in narrowing the differential diagnosis. Having the knowledge of the common radiographic manifestations of inflammatory arthritis is of paramount importance for clinicians and radiologists to diagnose the underlying disease in early stages of disease in order to start treatment. The purpose of the article is to review the key radiographic findings of common rheumatic diseases in the hands.

Hydrocephalus is defined as active distension of the brain’s ventricular system, resulting from inadequate flow of cerebrospinal fluid from its site of production to its site of absorption into the systemic circulation. Hydrocephalus can affect anyone at any age; pediatric hydrocephalus affects 1 in 1,000 live births and is the most common cause of brain surgery in young patients. Hydrocephalus is a pathological condition characterized by abnormal accumulation of cerebrospinal fluid (CSF) due to increased production, impaired flow, or reduced absorption. Ventricular enlargement occurs in response to increased CSF volume and can lead to structural damage to the brain parenchyma. This condition can be congenital or acquired. One key point in prenatal diagnosis is the differentiation between fetal hydrocephalus and non-hypertensive ventriculomegaly. The former qualifies for intrauterine treatment with good outcomes. However, the latter can result in either favorable or catastrophic outcomes due to a damaging etiology, as seen in viral infections such as Zika virus. For an accurate diagnosis, fetal MRI is performed to detect brain anomalies, in addition to fetal ultrasound (to detect common complications), karyotype testing, and TORCH testing (toxoplasma, rubella, cytomegalovirus, herpes simplex). Obstetric management of fetal hydrocephalus depends on the gestational age at diagnosis and the presence of other anomalies. Treatment options include termination of pregnancy before the fetus is viable, placement of a ventriculoamniotic shunt, cephalocentesis before delivery, and/or cesarean section.

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.

Micro, Small, and Medium Enterprises (MSMEs) of chips in Pugeran Village, Gondang District, Mojokerto Regency face structural obstacles in the form of limited internal governance and weak market penetration. Around 80% of business actors are still managed conventionally, triggering production inefficiencies and a lack of mastery of persuasive marketing language on packaging. This community service activity aims to reconstruct an effective division of labor based on HR governance mindset, build the capacity of practical skills in packaging copywriting and digital media, and change business behavior from conventional reactive to strategic proactive. The program is implemented with an Asset-Based Community Development (ABCD) approach through three main intervention stages, namely diagnosis and reconstruction of MSDM, co-creation and marketing language assistance, and the adoption of proactive behavior through coaching and market simulation. The results showed a significant socio-economic transformation, characterized by the implementation of labor division SOPs that increased production efficiency by 18%, as well as the adoption of new packaging and persuasive copywriting techniques that expanded market reach beyond the region and increased average turnover by 22% in two months. In addition, a new social institution was formed in the form of the "Prosperous Pugeran Chips Craftsmen Association" and the emergence of young local leaders as agents of the program's sustainability.

Hyperemesis gravidarum is excessive nausea and vomiting in pregnant women to the point of interfering with daily activities. Hyperemesis gravidarum affects the mother's physiological condition. Continuous nausea and vomiting can cause carbohydrate and fat reserves to be used up for hormonal needs, resulting in activity intolerance, and imperfect fat oxidation, resulting in ketosis. This case study aims to explain Nursing Care for Patient Mrs. B with Hyperemesis Gravidarum Case in Providing Ginger Water Decoction to Reduce Nausea and Vomiting in Pregnant Women in Arafah Room 3 RSUDZA Banda Aceh. This design is a case study with a nursing process approach, the results of the case study found three nursing diagnoses, namely nausea related to pregnancy, the risk of nutritional deficits related to psychological factors (reluctance to eat) and anxiety related to lack of exposure to information. The nursing actions given are providing non-pharmacological therapy: ginger decoction, encouraging patients to eat little but often and providing information about physiological symptoms in pregnant women in the first trimester, including nausea and vomiting. The results of the evaluation after 5 visits for the nursing diagnosis of Nausea related to pregnancy were obtained at the fifth visit. The subjective data evaluation of the client said that nausea was still felt occasionally, the client said that vomiting was no longer present, the client said that appetite had started to improve

Allergic rhinitis (AR) is an inflammatory process of the nasal mucosa initiated by a hypersensitivity reaction and caused by exposure to allergens mediated by immunoglobulin E (IgE), with several characteristic symptoms including: nasal congestion, a runny nose or watery nasal discharge (rhinorrhea), nasal itching, sneezing, and  postnasal drip (PND). According to the World Health Organization’s Allergic Rhinitis and its Impact on Asthma (WHO-ARIA) guidelines, based on the duration of symptoms, allergic rhinitis is classified into two categories: intermittent allergic rhinitis (symptoms lasting less than 4 days per week or for less than 4 weeks) and persistent allergic rhinitis (symptoms lasting more than 4 days per week and for more than 4 weeks). The prevalence of allergic rhinitis based on a doctor’s diagnosis is approximately 15%; however, it is estimated to reach 30% when considering patients with nasal symptoms. Appropriate management of allergic rhinitis, in addition to alleviating symptoms, is also expected to improve the quality of life of patients whose lives have been disrupted by the condition, as the higher the severity and frequency of allergic rhinitis symptoms, the greater the impact on reduced quality of life.

Drowning is one of the leading causes of accidental death worldwide and remains a major challenge in forensic investigations due to the complexity of determining the exact cause and mechanism of death. This study aimed to analyze forensic investigation methods used to determine the cause of death in drowning cases. The research employed a qualitative descriptive literature review approach by analyzing scientific articles, forensic journals, and medical references related to drowning investigations. Data were collected through literature searches from Google Scholar, PubMed, and Portal Garuda using keywords related to forensic drowning investigations. The findings indicate that forensic investigation in drowning cases requires a comprehensive approach involving external examination, autopsy, laboratory examination, histopathology, diatom analysis, toxicology, and crime scene investigation. Typical forensic findings include foam cone, washerwoman’s hands, cutis anserina, emphysema aquosum, and the presence of foreign materials in the respiratory and digestive tracts. Diatom examination and histopathological analysis also play important roles in strengthening the diagnosis of drowning. The study concludes that an integrated forensic investigation based on scientific evidence is essential to accurately determine the cause and manner of death in drowning cases and to support medicolegal processes in Indonesia.

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.

Schizophrenia is a severe mental disorder often accompanied by auditory hallucinations and has a significant impact on patients’ psychosocial functioning. This condition can reduce medication adherence, thereby increasing the risk of relapse. In this context, the role of caregivers is crucial in supporting treatment success. This study aims to describe psychiatric nursing care for patients with auditory hallucinations in improving medication adherence through caregiver involvement. The method used is a case study with a nursing process approach, including assessment, nursing diagnosis, planning, implementation, and evaluation. Interventions focus on hallucination management, psychoeducation, and caregiver involvement in care. The results show an increase in patients’ and families’ knowledge regarding the illness and its treatment, improved medication adherence, and enhanced patient ability to control responses to auditory hallucinations. Caregiver involvement has been shown to assist in supervision and providing support to patients. Therefore, comprehensive psychiatric nursing care through hallucination management, psychoeducation, and caregiver involvement is effective in improving medication adherence and controlling symptoms in patients with auditory hallucinations.

Patients with ANSD may have hearing thresholds that vary from normal to severe hearing loss, but they often have difficulty understanding speech, especially in noisy environments. This condition can be caused by various factors, including genetic mutations (such as in the OTOF gene), preterm birth, perinatal hypoxia, and hyperbilirubinemia. Some adult patients have been reported to develop ANSD following autoimmune disorders such as sensorimotor neuropathy or after chemotherapy with ototoxic agents such as cisplatin. Diagnosis of Auditory Neuropathy Spectrum Disorder (ANSD) begins with a comprehensive medical history to identify risk factors that play a role. A history of preterm birth, severe hyperbilirubinemia requiring exchange transfusion, perinatal hypoxia, ventilator use, and a family history of infection or genetic disorders are major risk factors. In addition, patients or parents often report delayed speech development, inability to understand speech (especially in noisy environments), or a discrepancy between previous hearing test results and the child’s behavioral response. The gold standard for diagnosing ANSD is a combination of: (1) positive OAE and/or CM, (2) absent or abnormal ABR, and (3) absent acoustic reflex. This diagnosis is established only if there is evidence that the cochlea is functioning normally but there is a disruption in auditory nerve transmission. Routine monitoring is conducted to assess hearing and language development and adjust devices and therapy methods according to the patient’s needs. Counseling and education for families are also crucial components to provide optimal support at home and improve the patient’s quality of life. A comprehensive multidisciplinary approach is essential to ensure effective management of ANSD and achieve the best possible outcomes.

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 analyze the role of assessment in decision-making within guidance and counseling services. Assessment plays a crucial role in providing accurate, objective, and comprehensive data regarding students’ characteristics, needs, and problems. This research employs a qualitative approach using a literature review method by analyzing 25 relevant scholarly sources related to assessment, measurement, and counseling services. The findings indicate that measurement serves as the fundamental basis of assessment, which involves systematic processes to obtain quantitative data. The quality of assessment results is highly influenced by the reliability and validity of the instruments used. Reliable instruments ensure consistency, while valid instruments ensure accuracy in measuring intended variables. Furthermore, assessment functions as a basis for diagnosis, planning, implementation, and evaluation of guidance and counseling services. The study also reveals that the application of assessment in schools is not yet optimal due to several factors, including limited counselor competence and lack of effective use of instruments. In addition, the integration of technology and the use of both test and non-test instruments have been shown to improve the accuracy and effectiveness of assessment. In conclusion, systematic and well-implemented assessment significantly enhances the quality of decision-making in guidance and counseling services. Therefore, improving counselors’ competencies and optimizing the use of assessment instruments are essential to support more effective counseling practices

This study aims to analyze the effect of direct learning on engine components toward students' vehicle diagnostic abilities in vocational education. Employing a quantitative approach with an ex post facto design, the sample consisted of 80 students selected using simple random sampling from a population of 100 students. Data were collected using validated and reliable questionnaires. The data analysis techniques included descriptive statistics, classical assumption tests, and simple linear regression analysis. The results show that direct learning has a positive and significant effect on students’ vehicle diagnostic abilities, with a significance value of 0.000 < 0.05 and a coefficient of determination (R²) of 0.264. This indicates that direct learning contributes 26.4% to the improvement of students' diagnostic abilities. The findings emphasize the importance of practical, hands-on learning approaches in vocational education. These approaches not only enhance students' understanding of automotive theory but also improve their diagnostic skills. The study highlights that systematic learning and direct interaction with engine components are key factors in developing students' competencies, making them more effective in real-world vehicle diagnostics.

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.

Inguinal hernia is a common abdominal hernia occurring in the groin region and generally requires surgical management, with postoperative pain control being an important aspect of patient recovery. This case reports a 55-year-old male presenting with a left groin mass for 6 months, which was initially reducible but subsequently became difficult to reduce, accompanied by severe pain and activity limitation. Physical examination revealed a left inguinal mass measuring approximately 3.03 × 2.17 cm, with firm consistency, well-defined borders, immobility, and tenderness, while ultrasonography demonstrated dilation of the left inguinal canal after provocation; based on these findings, a diagnosis of left inguinal hernia with ASA physical status II was established. The patient was managed with herniorrhaphy under regional anesthesia using a subarachnoid block, followed by ultrasound-guided ilioinguinal and iliohypogastric nerve blocks with levobupivacaine and pehacain for postoperative analgesia. Intraoperatively, the patient remained hemodynamically stable, and postoperatively, pain intensity decreased gradually from a VAS score of 6 to 2 within 24 hours and reached 0 on the second postoperative day without significant complaints. This case demonstrates that regional anesthesia combined with ultrasound-guided peripheral nerve block may support postoperative pain control after herniorrhaphy, maintain clinical stability, and improve patient comfort during recovery.

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

Sectio caesarea is a common surgical procedure to deliver a baby when normal delivery is not possible or risky. Postoperatively, patients often experience acute pain that can interfere with the recovery process. The benson relaxation technique is a nonpharmacological method that has been shown to be effective in reducing pain through a relaxation and patient confidence approach. This study uses a case study approach on Mrs. T, a post-sectio caesarea patient at Harapan Bunda Hospital, Batam City. Nursing care is carried out comprehensively for three days, including assessment, diagnosis, intervention, implementation, and evaluation. The main intervention was the administration of benzone relaxation techniques for 10–15 minutes every day. After three days of applying the Benson relaxation technique, Mrs. T's pain intensity decreased from a scale of 6 (moderate pain) to a scale of 2 (mild pain). Patients show increased comfort, ability to be active, and decreased expressions of pain such as grimacing. These results support previous findings that benzon relaxation is effective as a nonpharmacological therapy in reducing postoperative pain. This technique can be a safe and easy-to-apply alternative in nursing practice, especially for post-sectio caesarean patients.