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Abstract : Surgery or invasive procedures can pose risks to patients with hemophilia. Circumcision performed on patients with hemophilia can pose risks such as prolonged bleeding, infection, longer wound healing and increased morbidity. Data on circumcision in pediatric patients with hemophilia in Indonesia are still very few. The purpose of this study was to provide an overview of the clinical condition of children with post-circumcision hemophilia. This is a descriptive study who observed 9 hemophilia patients underwent circumcision in Haji Adam Malik General Hospital. The demographics data of the patients were collected from medial record including age, family history of hemophilia, type and severity of hemophilia. Among 9 hemophilia patients who underwent circumcision in Haji Adam Malik General Hospital Medan, 66.67% cases were diagnosed as hemophilia at under 10 years old. From 33.33% of the cases, the diseases were in mild and severe conditions. After the circumcision, all the patients were hospitalized and monitored by the vital signs and signs of bleeding. About 66.67% cases were hospitalized for <5 days, and 33.33% for 5-7 days. In our study, we found 55.56% cases have minimal bleeding on surgical wound, 11,11% cases have an active bleeding on surgical wound, 11.11% cases have spontaneous bleeding, and 22.22% cases have no bleeding. The subtitutive treatment by Factor VIII and Factor IX concenctrates were given one hour before circumcision and continue to be given in the following days, 66.67% patients are given for <5 days and 33.33% patients for 5-7 days. Circumcision of children with bleeding disorders especially hemophillia should be done carefully by surgeons and hematologist under appropriate conditions at comprehensive hemophilia centers even though bleeding diatheses are not an absolute contraindications for the procedure.

Abstract : The prevalence of people with autism spectrum disorder (ASD) is rising, making early screening crucial. As nutritionally vulnerable populations, a detailed nutritional assessment is essential in order to recommend timely and intensive interventions. A descriptive study design” was employed to assessment of the nutritional status of autistic patients in Alhilla city in. from 1st / November / 2021 to 26st June 2022. Convenience (non-probability) sample" consisted of (200) samples, which is chosen during the sampling process through the period from(27th January 2022 to 5th April 2022). The majority of ages of sample were within the 25-36 years old category by about (49.0%). The majority of the study's participants (33.0% and 59.0%) were educated and in institute school respectively. there is statistically high significant association between nutritional status and income monthly (P-value = 0.036). Also there is statistically high significant association between educational level and nutrition condition (P-value = 0.021). The higher percentage of parents were educated, most of them were within (25-36 years) age group. Most of child in the current study were less than three years mean age were 2.93 most of them were male. The majority of parents reported a moderate level of nutritional status concerning their autistic children. There is a significant relationship between nutritional status with a parent’s educational.

Abstract : Stunting remains a crucial issue in low- and middle-income countries. In Indonesia, interventions are mostly focused on children under two years old and rarely addressed older children. Stunted female children are at risk of becoming short-stature mothers which is one of the factors associated with stunting, thus may cause intergenerational effect. This cross-sectional study aimed to determine the prevalence and key determinants of stunting in primary school-age girls. A total of 177 girls from five randomly-selected primary schools in five districts were included in the study. Data were collected by questionnaire interviews with parents. Children's height was directly measured using microtoise and then calculated by WHO AnthroPlus to identify nutritional status. Our result revealed the prevalence of stunting among primary school girls in urban Surakarta City was 10.17%. Analyses showed significant determinants of stunting were short birth length (p<0.001, OR 8.21), low birth weight (p<0.001, OR 8.14) and infection in the past 6 months (p<0.05, OR 6.27). However, breastfeeding practice, maternal height, maternal education, family income, and toilet facility were not significantly associated with stunting in urban Surakarta.

Abstract : Uncontrolled hypertension can cause heart disease, stroke, kidney failure, so it is necessary to know the factors causing it to be able to provide education and preventive interventions. This study aims to determine the factors that influence uncontrolled hypertension in rural areas. The study used case control. Research respondents consisted of 225 hypertensive patients in rural Indonesia consisting of 194 patients with uncontrolled hypertension and 31 patients with controlled hypertension. The operational definition of uncontrolled blood pressure is if the measurement results in blood pressure > 140/90 mmHg. Data were collected using a questionnaire consisting of demographic data, health history and lifestyle consisting of medication adherence, alcohol drinking habits, smoking habits, high sodium consumption, high fat consumption and exercise habits. Data analysis used chi square and logistic regression. Majority of uncontrolled blood pressure (86.2%), age over 55 years old (47.6%), female (78.2%), low education (84.9%), not working (52.4%), Overweight-obese (67.6%). The results of the analysis showed that the level of education (p=0.033; OR=8.735; 95%CI=1.187-64.290), high sodium consumption habits (p= 0.013; OR=3.311; 95%CI= 1.292-8.483) and medication adherence (p=0.002; OR=3.885; 95%CI=1.678-8.998). Education level, high sodium consumption habits and medication adherence influence uncontrolled hypertension in rural areas dominantly.

Abstract : This study aims to investigate the effect of the leadership skill training module on motivation score of the nurses. Leadership skill does give a big impact on staff working motivation. Each leader should receive leadership skill training to ensure that they have good skill in managing their staff. Methods that had being used in this study is a cross-sectional- interventional study, 96 nurse managers and 400 nurses were selected from two teaching hospitals in Malaysia (2018-2019). Data were analyzed using descriptive and inferential statistics in SPSS 24. The results shown that the statistical analysis of the median of the nurses’ motivation scores after the leadership skill training module has no significance (P=0.001). In conclusion, the results showed that nurses were not impressed with the leadership styles used by their managers. There was no change in the leadership style of the nurse manager despite being given training on leadership skills. Leadership skill training should give an implication for nursing management. A leadership skill training module, should being used to improve the nurses’ leader’s skill in managing their nurses. By improving the relationship between leaders and nursing staff, it will indirectly enhance the working motivation among them. Studies related to this area should be conducted more as it helps to improve knowledge to ensure the development of nursing leaders.