Introduction: Hemodialysis patients have physical vulnerability due to the progressive decline of the body's systems. The physical changes in the patients can lead to haemostatics failure, known as frailty syndrome. The frail condition can cause maladaptive psychological responses due to changes that can cause anxiety in patients.Objective: This study aims to determine the prevalence of frailty in hemodialysis patients and to find out the different factor that correlates in frailty patients undergoing hemodialysis therapy.Method: This is a cross-sectional study involving 55 respondents who underwent hemodialysis therapy at the Jember Klinik Hospital. The instruments used in this study were the Edmonton Frail Scale (EFS) and the Hamilton Anxiety Rating Scale. Results: Moderate frailty was found in 23 patients (41.8%), followed by mild frailty in 18 patients (32.7%) and severe frailty in 14 patients (25.5%). In terms of anxiety, 18 patients (32.7%) had severe anxiety, 20 had moderate anxiety (36.4%), 12 (21.8%) had mild anxiety, and the other 7 (12.7%) were not anxious. The statistical analysis shows a significant difference in the average level of anxiety and the frailty status (p<0.001) among the patients. Conclusion: Frailty was highly prevalent in hemodialysis patients and had relations with anxiety and different sociodemographic characteristics of patients. The assessment of frailty should be considered when clinicians intervene and prevent worsening in patients.

Background: Breast milk is the best food for babies, needed for optimal growth and development. The lack of milk production influences the low coverage of exclusive breastfeeding. Increasing breast milk production could be done non-pharmacologically, using warm herbal compresses as breast care.Purpose: Analyze the effect of warm herbal compresses as breast care on oxytocin hormone and postpartum mother's milk production. Methods: Quasi-experimental design pretest-posttest with the control group, respondents were 36 normal mothers on the third day of postpartum; 18 respondents intervention group, and 18 respondents control group. Warm herbal compresses were provided once per day with 20 minutes on each breast for three days. The oxytocin hormone was measured pre and post three days of treatment, the volume of breast milk was measured pre, post 2, and 3 days of treatment.Results: The intervention group's average difference in oxytocin hormone was 24.65 pg/ml, the control group was 2.48 pg/ml (p<0.01). The average increase in milk production pre and post-three days of treatment in the intervention group was 32,250 ml. In the control group, 26,472 ml (p<0.01), there was a significant difference in the average milk production between the two groups.Conclusion: Warm herbal compresses as breast care affects the oxytocin hormone and postpartum mother's milk production.

Background: Currently, several companies offer Bluetooth-based electronic stethoscopes. However, the stethoscopes are pretty overpriced. In this case, we need a stethoscope innovation with a more affordable price that carries the same function and improves ear sensitivity during auscultation of heart and lung sounds.Technic: This stethoscope is equipped with a condenser mic that functions as a sound catcher on the stethoscope membrane. The analog data of the condenser mic is regulated by the potential of the pre-amp mic amplifier; then, analog data is forwarded using Bluetooth 5.0 A2DP BT600 USB Wireless Audio Transmitter and received by Bluetooth receiver using earphones.Conclusion: A electronic stethoscope has been successfully developed, which can function adequately to detect, increase heart, lung, bowel sounds, and prenatal sounds.

Background: Sepsis is a significant health problem worldwide. Various sepsis biomarkers have been studied before, but few data link PCT and urinary nitrite levels to culture result in septic patients.Purposes: This study compares PCT, Urine Nitrite on culture results against their sensitivity to determine variables that can be used to predict sepsis patients.Methods: This is a cross-sectional study by taking data on patients with sepsis aged ≥18 years in 207. Diagnostic tests were performed to determine sensitivity and specificity of PCT, Urine Nitrite, and Blood Culture of septic patients. A Chi-square test was carried out to see the relationship between two parameters and the outcome of sepsis.Results: PCT sensitivity was higher than Urine Nitrite: 74.5%. Specificity of Urine Nitrite was higher than PCT: 88.2%. Procalcitonin has a significant relationship with sepsis patient outcomes (p<0.005).Conclusion: PCT can predict septic patients because it has a higher sensitivity than urine nitrite

The development of the COVID-19 vaccine is currently quite encouraging amid increasing mortality and transmission of the COVID-19 virus in various countries. Apart from vaccination, the government also needs to consider vitamin D supplementation policies because it has a significant role in boosting the immune system.

Background: Researches on applying ice gel and aloe vera gel compress to reduce perineal wound pain scale after childbirth has been widely studied and proven effective. However, the effectiveness of using both has not been studied.Objective: The purpose of this study was to determine the effectiveness differences of ice gel and aloe vera gel in reducing the intensity of perineal wound pain.Methods: It applied a quasi-experimental research design. The population was 116 post-partum mothers, a sample of 56 mothers with sutured perineal wounds grade II, divided into two groups of intervention (aloe vera gel compress) and control (ice gel compress), with a consecutive sampling technique. The pain before and after the intervention was observed and analyzed using the Wilcoxon and Maan Whitney tests.Result: The mean reduction in pain scale in the group with the aloe vera gel treatment was more than that in another group with ice gel treatment, with a mean difference of 2.46 and 1.61. The statistical analysis results showed a significant difference in pain relief between the two groups, p<0.05.Conclusion: The aloe vera gel compresses are more effective than the ice gel compresses in reducing the scale of perineal pain after childbirth.

Background: cases of premenstrual syndrome (PMS) among teenagers living in Hurun Inn Boarding School at the Pondok Pesantren Darul 'Ulum Jombang are quite a lot. In the 60 teenagers get surveyed, there were 22 (36.67%) people who experienced PMS. It means the problems need acute treatment to overcome.Case presentation: This case study reports the effectiveness of giving abdominal stretching to ten teenagers who have PMS at the boarding school. The results showed a decrease in the PMS scale from a severed level (70%) to a medium-scale (60%) in the first cycle of menstruation and a mild level (60%) in the second cycle.Conclusion: Abdominal stretching can reduce PMS symptoms.

Background: Quality of life (QoL) among the elderly is a neglected issue, especially in developing countries, including Indonesia. The QoL of the elderly is dependent on four domains. Living arrangements play an important role in determining QoL.Objective: The present study aimed to compare the differences in QoL among community-dwelling elderly and in social welfare institutions.Methods: This was a cross-sectional study. Participants were sampled from two settings: social welfare institutions and the community. The study subjects in each area were selected using a simple random technique. The total sample were 163 respondents. QoL was assessed through the WHOQOL-Bref. Data analysis was performed by the Mann-Whitney U Test.Results: There were significant differences depending on the residence of the elderly: the average QoL in a community is higher (84.16) than in social welfare institutions (63.95), and p-value < 0.001.Conclusions: The results of our study indicate that community-dwelling elderly have higher QoL compared to residents of social welfare institutions.

Background: Patients need help from others to meet their needs during hospitalization in the Intensive Care Unit (ICU). The role of the family is significant in the care of critical patients in the ICU because it helps fulfill the satisfaction and providing supportive care of patients related to their intimacy.Objectives: This study aims to explore the role of families in the hospitalization of critical patients in the ICU.Method: This study used a qualitative method with a phenomenological approach. Data retrieval is done through in-depth interviews, focused group discussions, and observations. The participant recruitment technique uses pur-posive sampling. The research participants were 24 people and were following with the inclusion criteria. Source triangulation is done to find out the validity of research data and the roles performed by the family. This qualitative data was analyzed using N-Vivo 12 plus methods.Results: There are five themes accompanied by 12 sub-themes in them, including developing emotional relationships with patients, providing physical support to patients, becoming information partners with health personnel, fami-lies, and patients, supporting patient facilities and infra-structure, families meeting patients' spiritual needs.Conclusion: Family members are involved in patient care because families are given the opportunity and sufficient time to visit patients. Suggestions for further research can consider the family background in the involvement of roles and factors that influence family roles during hospitalization of patients in the ICU.

Viruses have been around for billions of years ago. They are everywhere, with varieties of shapes and sizes. They are microparasites with the ability to evolve and mutate. Some viruses can be so malignant and cause an outbreak that kills hundreds, and even millions, of people. What the world recently faces is one of those malignant viruses.