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Dental caries is an oral health problem associated with the activity of Streptococcus mutans. Water hyacinth (Eichhornia crassipes) contains bioactive compounds such as flavonoids, tannins, and alkaloids with antibacterial potential. This study aimed to evaluate the effectiveness of water hyacinth extract against the growth of Streptococcus mutans. The research method used was an in vitro experimental study with a post test only group design. A total of 24 samples were divided into four treatment groups with extract concentrations of 6.25%, 12.5%, 25%, and 50%. Antibacterial activity was tested using the disc diffusion method on Mueller Hinton Agar media. Data were analyzed using the Kruskal-Wallis and Mann-Whitney tests. The results showed that water hyacinth extract inhibited the growth of Streptococcus mutans. The largest inhibition zone was observed at 50% concentration, while the smallest was found at 6.25% concentration. Kruskal-Wallis analysis showed significant differences among groups (p<0.05). In conclusion, water hyacinth (Eichhornia crassipes) extract has antibacterial activity against Streptococcus mutans.

Muscle-invasive bladder cancer (MIBC) is an aggressive malignancy associated with high morbidity, reduced survival, and impaired quality of life. Radiotherapy (RT) has been widely used as a bladder-preserving strategy, particularly for patients unsuitable for surgery or systemic chemotherapy. RT may also enhance tumor immunogenicity through programmed death-ligand 1 (PD-L1) upregulation, providing a rationale for combination therapy with immunotherapy. This study aimed to evaluate the effectiveness of combining immunotherapy and radiotherapy in MIBC treatment. A systematic review was conducted following PRISMA 2020 guidelines using the PICO framework. Literature searches were performed in PubMed, Embase, Cochrane, ClinicalTrials.gov, Web of Science, and Scopus databases for studies published between 2016 and 2025. Risk of bias was assessed using the Cochrane Risk of Bias Tool and ROBINS-I. Of 105 identified studies, five met the inclusion criteria and were included in the final analysis. Only one Phase II randomized controlled trial demonstrated low risk of bias in randomization and allocation concealment. ROBINS-I assessment indicated moderate to serious risk in confounding and participant selection domains. Clinical findings showed promising outcomes, with complete response rates ranging from 35%–50% and partial response rates from 25%–40%. Median overall survival ranged from 24–30 months, with favorable disease-free and progression-free survival outcomes. Combined immunotherapy and radiotherapy demonstrate potential to improve survival and disease control in MIBC; however, further rigorous clinical studies are needed to optimize patient-centered treatment strategies.  

Breast cancer remains a major global health challenge, with treatment effectiveness often limited by drug resistance and the toxic side effects of chemotherapy on normal cells. The exploration of bioactive compounds from natural sources through a medicinal chemistry approach offers a promising alternative strategy. This study aims to examine the molecular mechanisms of action and Structure-Activity Relationships (SAR) of various natural compound scaffolds as potential breast anticancer agents. The method employed was a systematic narrative literature review of 15 recent scientific articles evaluating computational parameters, including molecular docking, as well as in vitro and in vivo activities. The results indicate that polyphenols, flavonoids such as quercetin and EGCG, and curcumin possess strong cytotoxic activity and high binding affinity toward cancer-related target macromolecules. SAR analysis demonstrates that key structural features, including the number and position of free phenolic hydroxyl groups, the presence of gallate ester groups, and conjugated diketone systems, play a crucial role in determining ligand receptor complex stability. These interactions are supported by hydrogen bonding, hydrophobic interactions, and favorable steric compatibility within receptor binding sites. Computational findings further suggest that structural optimization can enhance ligand selectivity and improve pharmacokinetic properties. This study concludes that natural phytochemical scaffolds have significant potential as lead compounds and provide a rational basis for Computer-Aided Drug Design in developing more potent, selective, multi-target, and safer breast anticancer therapies.

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.

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.

Introduction: Ramadan fasting is a religious practice observed by Muslims by abstaining from food and drink from dawn until sunset. These changes may increase the need for oral and dental healthcare. However, some Muslims still perceive that undergoing dental treatment while fasting may invalidate the fast, leading many patients to delay or avoid dental visits during Ramadan. Objective: This study aims to review and analyse various scientific literature regarding the safety and permissibility of dental procedures for patients who are observing fasting during Ramadan. Methods: This study used a narrative review method by searching scientific articles through PubMed, ScienceDirect, and Google Scholar databases using keywords relevant to the research topic. Articles were selected based on predetermined inclusion and exclusion criteria. Results: The review findings indicate that most dental procedures, such as local anaesthesia administration, scaling, restorative treatment, and tooth extraction, generally do not invalidate fasting as long as no material or fluid is intentionally swallowed. The use of suction devices, isolation of the treatment area, and proper scheduling of dental procedures are important factors in minimizing the risk of swallowing fluids during treatment. Conclusion: Most dental procedures can be safely performed on fasting patients while still considering both medical aspects and Islamic principles. Patient education regarding the safety of dental procedures during fasting should be improved to prevent delays in treatment and complications in oral health.

The optimal therapeutic impact of local vaginal drug delivery systems is strongly influenced by the physical characteristics balance of Solid Vaginal Suppositories. A comprehensive review regarding the comparison of mechanical profiles, specifically melting time and crushing strength parameters, from various base classifications constitutes the primary objective of this literature research. The implementation of a Literature Review study design was executed through the extraction of empirical data from twelve experimental journals published within the last ten years. Excessively rapid phase transformation characteristics at physiological basal temperatures and low compression resistance were consistently demonstrated by lipophilic bases such as Oleum Cacao. The risk of structural deformation during the distribution process is highly susceptible to unmodified lipid preparations. High surface elasticity accompanied by a delay in molecular hydration duration reaching 120 minutes was recorded in the utilization of Glycerinated Gelatin Base. Structural rigidity exceeding 4 kgF and disintegration time efficiency under 60 minutes were optimally demonstrated by Polyethylene Glycol (PEG) Base. An enhancement in mechanical resistance against external shocks during the storage period is offered by the thorough modification of the synthetic polymer ratios. Therefore, the determination of the PEG base as the most optimal material is recommended to maintain the quality stability of pharmaceutical products. Compendial regulation standards regarding the physical strength testing of pharmaceutical preparations must be obeyed by every institution to ensure long-term treatment effectiveness. Thus, the alignment between active substance release duration and physical preparation endurance can be realized for absolute patient comfort.

Hypertension is a condition where blood pressure increases above normal limits as indicated by systolic and diastolic values ​​during examination. In Karanglangit Village, the community's low level of knowledge regarding risk factors, prevention and treatment of hypertension is an obstacle in controlling this disease. This service activity aims to increase public understanding so that they are able to implement efforts to prevent and manage hypertension independently. The method used is direct counseling with the help of presentation media and educational posters. The activity stages include completing a pre-test, providing material about hypertension, an interactive discussion session, and a post-test. The activity was carried out in January 2026 at the Karanglangit Village Hall, Lamongan District, with 26 PKK women participating. The results show an increase in participants' knowledge, marked by an increase in the average score from 76.92% in the pre-test to 100% in the post-test. The paired t-test showed a significant difference before and after the counseling (p<0.001), so that the activity was considered effective in increasing community knowledge. Apart from that, participants also better understand the importance of a healthy lifestyle, regular check-ups, and compliance in maintaining stable blood pressure.

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.

Critically ill patients are individuals with unstable health conditions who require close monitoring of hemodynamic parameters. The high mortality rate among critically ill patients treated in intensive care units reaches 36.5% of 33,148 patients. Hemodynamic instability in critically ill patients can be influenced by underlying diseases, medical interventions, as well as physical and psychological stress responses during treatment. Therefore, in addition to pharmacological therapy, non-pharmacological interventions such as Asmaul Husna dhikr therapy are needed, as they can provide a relaxation effect and help stabilize hemodynamic parameters in critically ill patients. To determine the outcomes of the implementation of Asmaul Husna dhikr therapy. This study used a descriptive case study method involving two critically ill patients with unstable non-invasive hemodynamic parameters. Changes in non-invasive hemodynamic parameters were observed in both respondents after the implementation of Asmaul Husna dhikr therapy. In respondent 1, the hemodynamic status was initially categorized as increased and became stable after the intervention. Similarly, in respondent 2, the hemodynamic status changed from increased before the intervention to stable after the intervention. The implementation of Asmaul Husna dhikr therapy can be used as a complementary therapy to help stabilize hemodynamic parameters in critically ill patients.

Thalassemia is a chronic genetic disease that requires long-term treatment and affects children's quality of life physically, psychologically, socially, and academically due to chronic anemia and regular blood transfusion needs. This study aimed to determine factors influencing the quality of life of children with thalassemia at Rumah Sakit Anak dan Bunda Harapan Kita. A descriptive design with a cross sectional approach was used, involving 41 respondents through total sampling. Data were collected using the Pediatric Quality of Life Inventory (PedsQL 4.0 Generic Core Scale) and respondent characteristics including age, gender, socioeconomic status, parental education, and frequency of blood transfusions. Data were analyzed using univariate and bivariate analysis with the Chi-Square test. The results showed most respondents were under ten years old, female, from families with socioeconomic status below the minimum wage, had parents with high school or higher education, and received blood transfusions every three weeks. Bivariate analysis indicated only the frequency of blood transfusions was significantly associated with quality of life, while other variables were not. Thus, transfusion frequency is the main factor influencing quality of life in children with thalassemia.

Background: Nallaswamy Class III alveolar ridge refers to an edentulous alveolar bone that has undergone resorption, resulting in a moderate ridge height with a knife-edge ridge form. This condition is relatively common and has been reported to reach a prevalence of approximately 89% in edentulous mandibles. Objective: To describe the prosthodontic treatment implications in patients with Nallaswamy Class III alveolar ridge using an acrylic resin removable partial denture (RPD). Case Report: A 22-year-old female patient presented to RSGM Soelastri with complaints of discomfort while chewing due to the loss of several posterior teeth in the mandible. The teeth had been extracted three years earlier due to caries and retained roots. Intraoral examination revealed healthy dentition in the maxillary arch and edentulous areas at teeth 35, 36, 45, and 46 in the mandibular arch. The alveolar ridge in the edentulous area showed a knife-edge form with moderate height, consistent with Nallaswamy Class III. Discussion: The condition was classified as Applegate-Kennedy Class III modification 1P with bilateral bounded saddle areas, which may affect mastication, aesthetics, and speech. Conclusion: Partial edentulism with a knife-edge alveolar ridge can be effectively managed using an acrylic resin removable partial denture.

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.

Gastritis is an inflammation of the gastric mucosa that often causes pain in the epigastric area, which can reduce patient comfort and quality of life. This condition requires treatment that is not only pharmacological, but can also be supported by non-pharmacological interventions such as warm compresses that function to provide a relaxing effect and improve blood circulation. This study aims to determine the effect of warm compresses on reducing pain intensity in gastritis patients. The research method used was descriptive with a case study approach on one patient treated in the inpatient ward. Data collection was carried out through interviews, observation, and documentation using the PQRST method to assess pain. The intervention in the form of warm compresses was given for three days with a frequency of once a day for ± 15–20 minutes in the epigastric area. The results showed a gradual decrease in pain intensity from a scale of 6 to a scale of 2 after the intervention, as well as an increase in patient comfort. The implications of this study indicate that warm compresses can be used as an effective, safe, and easy-to-implement independent nursing intervention to help reduce pain in gastritis patients and improve the quality of nursing care.

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

Vegetables are food commodities widely consumed by the public due to their high nutritional content. Chili (Capsicum annuum L.), green beans (Phaseolus vulgaris L.), and Chinese cabbage (Brassica pekinensia L.) are among the vegetables that can be processed into various delicious dishes or consumed fresh as raw vegetables. To obtain healthy and high-quality vegetable crops, pesticides are commonly used to control pests that may damage the plants. One of the widely used pesticides is chlorpyrifos, which can leave residues that may pose both acute and chronic health risks. Therefore, it is necessary to analyze the levels of chlorpyrifos pesticide residues in vegetables. The residue levels were determined using a UV-Vis spectrophotometer at a wavelength of 230 nm with dichloromethane as the solvent, while qualitative analysis was performed using HPLC by comparing the retention times of standard solutions and vegetable samples. In this study, washing treatments were applied to the vegetables using dichloromethane, distilled water, well water, and tap water (PDAM) to evaluate the effect of washing on pesticide residue levels. The concentrations of pesticide residues in unwashed vegetables were chili (2.6680 ± 0.0214 mg/kg), green beans (2.4658 ± 0.0193 mg/kg), and Chinese cabbage (2.7950 ± 0.0379 mg/kg). The washing process was carried out three times for each solvent. After three washings using dichloromethane and distilled water, pesticide residues were no longer detected, whereas washing with tap water (PDAM) and well water still left residues, although at levels much lower than the Maximum Residue Limit (MRL). The health risk assessment showed that the aHQ and cHQ values were < 1, indicating that consumption within the recommended limits of these samples does not pose health risks, either in the short term or long term. This study provides important information that repeated washing is necessary to effectively reduce pesticide residue levels in vegetables before consumption.  

Edentulism is a condition of total tooth loss that has a significant impact on the efficiency of mastics, phonetics, and facial aesthetics. This case report presents the rehabilitation of a 72-year-old female patient with a condition of total mandible edentulus using two standard-diameter implants that support the overdenture with a locator retention system. Treatment procedures include clinical evaluation, radiographic analysis, implant placement, prosthesis placement, as well as follow-up evaluation to assess function and comfort. The results of the treatment showed an increase in patient retention, stability, and comfort in daily activities. In addition, patients reported improved confidence and quality of life after the use of implant-based overdentures. These findings confirm that overdenture with mandibular implant support is a predictive, effective, and reliable rehabilitation method in treating total edentulism. The success of this case provides clinical evidence that implant-based approaches are able to overcome the limitations of conventional prostheses, as well as being a solution that supports the functional and psychosocial aspects of elderly patients. Thus, implant-based overdenture can be recommended as the primary therapeutic option in the rehabilitation of mandibular edentulism.

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.

Background: Class II restoration according to the classification of Greene Vardiman Black is one of the procedures in dental conservation that often presents a challenge for operators or dentists during treatment. Class II restorations have their own level of difficulty, particularly during the placement of restorative materials into the cavity. One of the possible failures in Class II restorative treatment is marginal leakage, which can lead to microleakage at the restoration margins. Purpose: To report the success of class II restoration with composite resin using tofflmire matrix. Case report: A 23-year-old female patient came with a complaint of cavities, the complaint was felt since 1 year ago in the lower left back tooth, there was no pain and had never been treated. In the case, preparation and restoration were carried out using composite resin with isolation using tofflmire matrix, applied using an Incremental technique. Discussion: Class II posterior tooth restorations have challenges such as leakage due to the techniques and materials used. Composite resin is chosen because of its good adaptation, esthetics, and wear resistance. Incremental techniques are preferred because they reduce polymerization stress and provide optimal curing results. Tofflemire matrix is ​​used for stability and soft tissue protection.Conclusion: The selection of composite resin with an Incremental technique and the use of a Tofflemire matrix provides more optimal, aesthetic, and minimal risk of failure results for class II posterior tooth restorations.