Rumah Sakit Dokter Soetomo

Surgical procedures can lead to various postoperative clinical problems such as pain, anxiety, nausea and vomiting, sleep disturbances, and fatigue, all of which require comprehensive management. Reflexology, as a non-pharmacological complementary therapy, has the potential to support postoperative management through stimulation of reflex points on the soles of the feet, hands, and ears. This study aims to synthesize scientific evidence regarding the effectiveness of reflexology as a complementary intervention in postoperative patient management. A systematic review was conducted following the PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus, Web of Science, CINAHL, EBSCOhost, and the Cochrane Library for publications from January 2010 to December 2024. The inclusion criteria were determined using the PICO framework, and methodological quality was assessed using the JBI Critical Appraisal Tools. Out of 1,032 identified articles, 15 studies met the inclusion criteria (13 randomized controlled trials, 1 clinical trial, and 1 randomized study). The synthesis results indicate that reflexology significantly: (1) reduces postoperative pain intensity, (2) decreases anxiety levels, (3) stabilizes physiological/hemodynamic parameters, (4) improves sleep quality, and (5) reduces fatigue. These effects were consistently observed across various surgical procedures, including coronary artery bypass graft (CABG), abdominal surgery, hysterectomy, and cesarean section. Reflexology has the potential to serve as a safe, effective, and practical complementary intervention to support postoperative patient management. Further studies with multicenter designs, larger sample sizes, and more standardized protocols are recommended.

Meningioma merupakan tumor intrakranial primer yang paling sering ditemukan pada orang dewasa. Walaupun sebagian besar bersifat jinak, tumor ini dapat menimbulkan dampak klinis signifikan karena menekan struktur otak dan saraf. Variasi lokasi membuat manifestasi neurologis meningioma sangat heterogen, namun kajian yang secara khusus merangkum gejala praoperatif masih terbatas.Penelitian ini bertujuan untuk mengidentifikasi dan merangkum manifestasi klinis neurologis pada pasien meningioma berdasarkan literatur terbaru periode 2020–2025. Penelitian ini merupakan systematic literature review yang dilakukan sesuai pedoman PRISMA. Pencarian artikel dilakukan pada PubMed, ScienceDirect, dan Scopus menggunakan kata kunci “Meningioma” AND “Neurological Manifestations”. Kriteria inklusi adalah penelitian primer pada pasien dengan diagnosis meningioma yang melaporkan manifestasi neurologis praoperatif. Artikel yang berupa review, editorial, laporan konferensi, studi hewan, atau berfokus pada bedah dan radioterapi dieksklusi. Analisis dilakukan secara deskriptif naratif berdasarkan hasil ekstraksi data. Sebanyak 10 artikel memenuhi kriteria inklusi. Gejala yang paling sering dilaporkan adalah sakit kepala dan kejang. Manifestasi spesifik bervariasi sesuai lokasi tumor: gangguan visual pada meningioma sellar dan optikus, gangguan pendengaran dan fasialis pada meningioma kanalis auditorius interna, serta defisit motorik pada meningioma falx dan spinal. Beberapa laporan menunjukkan gejala atipikal seperti hematoma subdural akut. Temuan ini menegaskan pentingnya pengenalan dini terhadap variasi gejala meningioma dalam praktik klinis. Spektrum manifestasi neurologis meningioma luas dan sangat bergantung pada lokasi tumor. Pemahaman mengenai pola gejala praoperatif dapat membantu klinisi dalam diagnosis dini dan perencanaan penatalaksanaan.

This research aims to analyze the dynamics of interactions among three driving factors—personal attitudes (benefit/risk evaluation), subjective norms (husband/family support), and behavioral control (access, cost, physical limitations)—in shaping motivation and actual behavior. A qualitative case study method with an exploratory design was applied, involving data collection through semi-structured interviews with 5 purposively selected primigravida participants at Griya Kamini. Data analysis adopted the Miles-Huberman-Saldana interactive model: condensation, data presentation, and conclusion drawing based on source triangulation, with NVivo 12 used for coding, categorization, and data visualization. The study results revealed that initial motivation was triggered by exposure to social media educational content and validated by health workers, with the main goal of normal childbirth. Informants experienced physical benefits (e.g., reduced back pain) and mental benefits (e.g., emotion control), as well as resolution of initial concerns through hands-on experience. Subjective norms (support from husbands and health workers) emerged as the strongest factors in converting motivation to actual participation. Behavioral control was facilitated by the facility's strategic location, despite time constraints and cost perceptions for some informants. In conclusion, these findings extend the Theory of Planned Behavior (TPB) by incorporating social media as a precursor and emphasizing the importance of family-based approaches alongside clinical and community collaboration to encourage primigravida pregnant women in prenatal yoga.

Bullying remains a serious problem in adolescent development, particularly due to its widespread impact on psychological, social, and emotional aspects. Adolescents who experience bullying tend to face obstacles in forming social relationships, including a decline in interpersonal communication skills that play an important role in daily interactions. This study uses a descriptive approach with the aim of identifying patterns of interpersonal communication and aspects of character strengths that emerge in adolescents who have experienced bullying. Data were collected through interviews, observations, and relevant measurement instruments to gain an in-depth understanding of the psychological condition of the subjects. The subjects in this study were three adolescents who were victims of bullying. The results of the study show that adolescent victims of bullying generally tend to withdraw from social interactions, experience barriers in expressing their thoughts, stress, anxiety, lack of motivation to study, and emotions, and exhibit low self-confidence in communication. In terms of character strengths, it was found that some character strengths such as courage, perseverance, and emotional regulation had declined, although some aspects such as empathy and gratitude were still evident in some subjects. Keywords: Interpersonal Communication, Character Strengths, Bullying

Invaginasi usus merupakan salah satu penyebab utama obstruksi usus pada bayi dan anak-anak. Diagnosis yang cepat dan akurat sangat penting untuk mencegah komplikasi serius sehingga ultrasonografi (USG) telah menjadi modalitas diagnostik pilihan karena sifatnya yang non-invasif, aman, serta memiliki sensitivitas dan spesifisitas yang tinggi. Gambaran ultrasonografi khas invaginasi meliputi Target sign atau Doughnut sign pada potongan transversal dan Pseudokidney sign pada potongan longitudinal. Laporan kasus ini memaparkan seorang bayi laki-laki berusia 1 tahun yang datang dengan keluhan nyeri abdomen, distensi abdomen, muntah, dan demam. Pemeriksaan ultrasonografi abdomen mengidentifikasi Target sign yang khas pada invaginasi. Pasien selanjutnya menjalani laparotomi eksplorasi dan reseksi segmen usus. Kasus ini menegaskan peran penting ultrasonografi sebagai modalitas utama dalam menegakkan diagnosis invaginasi pada anak karena Pseudokidney sign tidak terdokumentasi, gambaran Target sign sudah cukup kuat untuk konfirmasi diagnosis dan penentuan tindakan terapi. Deteksi dini invaginasi sangat krusial dalam mencegah progresi menjadi ileus total dan komplikasi serius lainnya.

Cryptococcosis represents a life-threatening opportunistic fungal infection with significant mortality rates among immunocompromised individuals, particularly those with advanced HIV/AIDS. While cryptococcal meningitis dominates the literature, pulmonary involvement remains underrecognized despite its prognostic significance. This case report aims to document the clinical presentation, diagnostic challenges, and fatal outcome of pulmonary cryptococcosis caused by the rare species Cryptococcus laurentii in a severely immunosuppressed HIV-positive patient, and to emphasize the importance of early bronchoscopic investigation and antifungal therapy. We report the case of a 44-year-old Indonesian male with a history of HIV/AIDS who presented with progressive shortness of breath, persistent cough, and intermittent fever over two weeks. He was non-adherent to antiretroviral therapy (ART) and had a CD4 count of fewer than 50 cells/mm³. Chest radiography showed bilateral infiltrates, and sputum culture grew Cryptococcus laurentii. Despite the initiation of broad-spectrum antibiotics and antifungal agents, his respiratory status deteriorated rapidly. Antifungal susceptibility testing confirmed sensitivity to amphotericin B, flucytosine, and fluconazole, yet the patient developed progressive respiratory failure. He ultimately succumbed to refractory hypoxemia on day 23 of hospitalization. This case highlights the diagnostic challenge of pulmonary cryptococcosis in advanced HIV, particularly with rare non-neoformans species. A high index of suspicion and early mycological investigation, including culture and species-level identification, are critical for timely diagnosis. This report contributes to the limited literature on C. laurentii pulmonary infections in Southeast Asia and underscores the importance of adherence to ART, as well as the need for early consideration of fungal infections in severely immunosuppressed patients presenting with atypical pulmonary findings.

The purpose of this study was to provide an understanding of leptospirosis so that diagnosis and treatment can be carried out quickly. This research method used a case study with a clinical approach, supporting examinations, and management of patients who were followed up during hospitalization. The results of this study indicate that early recognition of severe leptospirosis and comprehensive management are important factors in reducing mortality. The study concluded that healthcare professionals need to increase clinical awareness of leptospirosis in patients with fever, jaundice, and kidney disorders so that diagnosis and treatment can be initiated more quickly. Keywords: Leptospirosis, Multi-Organ Failure, Weil’s disease.