Digital Commons Network^™

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Hidradenitis Suppurativa, Jamie Y. Choe, Henry Lim, Marshall Hall, Christian Scheufele, Dustin V. Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder characterized by recurrent deep-seated nodules and painful abscesses with scars, fistulae, and sinus tracts that predominately affect the intertriginous sites. Onset typically occurs soon after puberty. Depending on disease severity, HS can lead to varying levels of pain, disability, and disfiguration with significant impacts on quality of life. Hidradenitis suppurativa is diagnosed clinically, and no diagnostic tests are specific to the disease. Therefore, clinicians must have the knowledge and competence to identify the clinical features of HS accurately. The purpose of this report is to provide descriptions of characteristic clinical presentations …

Sebaceous Gland Heterotopia Of The Esophagus: A Rare Incidental Finding During Upper Endoscopy, Samuel Ramos, Margaret-Anne Huntley, Eric Vargas, Jignesh Parikh, Vania Zayat

HCA Healthcare Journal of Medicine

Esophageal heterotopic sebaceous glands (EHSG) are an extremely rare finding within the esophageal epithelium. These glands are typically benign, presenting as small, yellow-white plaques or lesions observed on endoscopy, often in the middle third of the esophagus. Esophageal heterotopic sebaceous glands are generally asymptomatic, and surveillance is not required. While their origin is unclear, proposed mechanisms include metaplastic transformation and congenital development. Recognition and histologic confirmation are essential to distinguish EHSG from other esophageal lesions and to avoid unnecessary interventions. We report the case of a 55-year-old man in whom multiple diminutive plaques were identified in the mid-esophagus during esophagogastroduodenoscopy …

Comparing The Expression Of Estrogen Receptors, Progesterone Receptors, And Human Epidermal Growth Factor Receptor 2 Between Initial Biopsy And Excision Specimens In Invasive Breast Carcinoma Cases. Is There A Need For Universal Repeat Testing? Experience From A Community Hospital, Astrid M. Sacasa, Gul Emek Wymer, Susana Ferra

HCA Healthcare Journal of Medicine

Background

The current national recommendation is that breast biomarkers estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) testing should be done on all primary invasive breast carcinomas and on recurrent or metastatic tumors. Repeat testing on a subsequent excision specimen is not indicated unless results appear discordant with the histopathologic findings. The objective of the current study was to evaluate the need for adopting universal reflex re-testing of breast biomarkers in excision specimens in our institution.

Methods

The study population included 70 sequential invasive breast cancer patients where the results of ER, PR, and …

Opioid Free Anesthesia In Arthroscopic Knee Surgery: A Feasible Approach To Patient Care, Carson Gifford, Denise Vidal, Dail Kim, Austin Goff, Paul Reynolds

HCA Healthcare Journal of Medicine

Background

The opioid epidemic has prompted exploration of opioid-free anesthesia (OFA) techniques, but the optimal approach is still debated. While some OFA protocols substitute opioids with other agents, these alternatives can introduce their own risks. The objective of this study was to investigate whether eliminating intraoperative opioids without analgesic substitution in arthroscopic knee procedures affects postoperative pain control and opioid requirements.

Methods

We conducted a retrospective analysis of 205 patients who underwent arthroscopic knee procedures between August and November 2023. Patients were divided into 2 groups: those who received intraoperative fentanyl (25-200 mcg, n = 144) and those who received …

Psychological Adaptation In Colorectal Cancer Survivors: Pilot Study Findings, Anuja L. Sarode, Emily M. Su, Amber Kerstetter-Fogle, Steve Paciorek, Erica L. Laipply

HCA Healthcare Journal of Medicine

Background

In this pilot study, we examined psychological impacts of colorectal cancer (CRC), focusing on cancer-related posttraumatic stress disorder (CR-PTSD) symptoms, posttraumatic growth (PTG), and their relationship with coping strategies in surgically treated CRC patients.

Methods

This prospective pre- and postoperative pilot study assessed CRC patients at 2 time points, pre- and postoperative. Psychological symptoms were evaluated using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) and the PTG Inventory Short Form (PTGI-SF). Coping strategies were assessed using the Brief Coping Orientation to Problems Experienced (COPE) instrument. Changes in CR-PTSD, PTG, and coping …

Coping Beyond Cancer: Exploring Fear Of Recurrence In Colorectal Cancer Survivors—A Pilot Investigation, Emily M. Su, Steve Paciorek, Erica L. Laipply, Anuja L. Sarode

HCA Healthcare Journal of Medicine

Background

Evidence is limited on the fear of cancer recurrence (FCR) among colorectal cancer (CRC) survivors in the US, especially regarding patterns and trends of post-recovery coping mechanisms. This pilot mixed-methods study quantified FCR, examined its associations with Brief COPE domains, and contextualized coping through qualitative analysis.

Methods

Twenty-three patients who successfully underwent CRC surgery were included in this pilot study. Fear of cancer recurrence was measured using the FCR Inventory (FCRI) Short Form, and coping strategies were assessed with the Brief Coping Orientation to Problems Experienced (COPE) survey. Descriptive statistics summarized participant characteristics, FCR, and COPE scores. Spearman correlation …

An Acknowledgement To The Hca Healthcare Journal Of Medicine's Reviewers And Editors For The First Half Of 2026, Graig Donini

HCA Healthcare Journal of Medicine

The HCA Healthcare Journal of Medicine would like to thank those behind the scenes who make this publication possible. Our journal would not be possible without the assistance of our peer reviewers, authors, and board members.

Erratum: Presentation Of Cutaneous Large B-Cell Lymphoma, Leg Type

HCA Healthcare Journal of Medicine

This corrects the article “Presentation of Cutaneous Large B-Cell Lymphoma, Leg Type” in volume 6, issue 6 on page 527.

Ameliorative Effect Of Ethanolic Extract Of Nardostachys Jatamansi Against High Fat Diet Induced Dyslipidemia In Rats, Umanath Preethi, Govindaraj Sumathy, Nathiya Shanmugam

Chulalongkorn Medical Journal

ABSTRACT:

Background and objective: The present study aimed to evaluate the antioxidant and hypolipidemic effects of ethanol extract of Nardostachys Jatamansi (N.J) in a high-fat diet-induced obesity model in male Wistar albino rats.Materials and methods:36 male Wistar albino rats were randomly divided into six groups, each comprising six animals: Group I received a normal diet for 9 weeks, while Group II was fed a high-fat diet (HFD) for the same period. Groups III–VI were also given HFD throughout. From week 5, Group III received rosuvastatin (10 mg/kg), and Groups IV–VI were treated with Nardostachys Jatamansi. extract at 100, 200, and …

Assessing The Reliability Of Machine Learning Models In Classifying Depression Severity Using Facebook Text, Keito Yoneyama

Chulalongkorn Medical Journal

Depression is a growing global issue that requires urgent attention, particularly in Thailand. Without timely intervention, it can lead to serious consequences such as health complications, reduced social participation, and even suicide. Consequently, there has been increased research focused on developing algorithms to identify and classify social media data according to depression severity. This study aimed to evaluate the extent to which such algorithms are a suitable tool for the preliminary classification of Thai Facebook text into different levels of depression severity. The methodology involved data collection through surveys and Facebook scraping, followed by data preprocessing, feature engineering, and model …

Tracking Toward Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Christian Justin Carreon

Master's Projects and Capstones

Problem: Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety concern in acute care settings, contributing to increased morbidity, mortality, prolonged hospitalization, and substantial healthcare costs.

Context: At Hospital A, a tertiary referral center in Northern California, six adult CLABSIs were identified between June and December 2025 following an eight-month CLABSI-free period. Four events occurred in adult medical surgical telemetry. All peripherally inserted central catheter (PICC) line CLABSIs were attributed to gaps in maintenance bundle adherence and the lack of a standardized, real-time tracking mechanism for the PICC Team.

Interventions: A PICC Team Tracker was implemented as …

Development Of Ultrafast Protein Digestion And Standards Free Quantitation Methods For Mass Spectrometric Analysis, Praneeth Ivan Joel Fnu

Dissertations

A wide variety of biologically important molecules, such as enzymes, antibodies, hormones, transporters and receptors are proteins by composition and they play key roles in biological functions such as cellular regulation, communication, metabolism and physiological function. Protein dysfunctions and abnormalities are associated with numerous diseases, making proteins critical targets for understanding disease mechanisms and developing therapeutic interventions. Protein-based therapeutics such as monoclonal antibodies, hormones and vaccines gained popularity due to their high specificity, efficacy, and ability to treat complex diseases that are often difficult to address with small-molecule drugs.

Given the important role of proteins in a variety of biological …

Tracking Towards Zero: Implementing A Picc Team Tracker To Prevent Clabsis, Carolina Maria Gerodias Cayetano

Master's Projects and Capstones

Background: Central line-associated bloodstream infections (CLABSIs) remain among the most serious and costly healthcare-associated infections in acute care settings, with each event associated with significant excess mortality, prolonged hospital stays, and avoidable healthcare costs. At Hospital A, a 239-bed acute care facility, two of six total CLABSI events over a 12-month period were associated with peripherally inserted central catheters (PICCs), representing 33% of all facility CLABSIs and exposing a critical gap in standardized PICC line surveillance and maintenance bundle monitoring.

Problem: The PICC team lacked a systematic, real-time tracking mechanism to monitor central line maintenance bundle adherence across seven adult …

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

Transmutation Of Psychological Phenomena (Academic Burnout And Fomo) Into Cyanotype Art Creation, Zulfan Ali Mujtaba, Adi Kuntoro

Paradigma: Jurnal Kajian Budaya

The pressure of hustle culture and the Fear of Missing Out (FOMO) in the digital era have triggered an escalation of academic burnout among students, demanding alternative psychological recovery interventions beyond verbal clinical approaches. This research aims to explore the creation of alternative Cyanotype photography as a medium for catharsis and resistance against toxic productivity. Utilizing a Practice-Based Research methodology with an autoethnographic approach, data were extracted from the researcher's subjective experiences and transmuted into a visual artifact titled "Metamorfosis yang Lelah". The cultural studies approach and wabi-sabi aesthetics are specifically applied to analyze visual elements in the Prussian Blue …

Spatial Association Of Acute Respiratory Infection, Diarrhea, And Low Birth Weight With Stunting Prevalence In Indonesia, 2024, Dian Rosadi, Husaini Husaini, Triawanti Triawanti, Musafaah Musafaah

Kesmas

Stunting remains unevenly distributed across Indonesia, but national evidence integrating spatial analysis and spatial regression is limited. This study examined the spatial distribution of stunting and its associations with acute respiratory infection (ARI), diarrhea, and low birth weight (LBW) across Indonesian provinces. An ecological cross-sectional study used data from the 2024 Indonesian Nutritional Status Survey. Stunting-only analyses included all 38 provinces, whereas analyses involving ARI, diarrhea, and LBW included 37 provinces with complete data. Spatial analyses used a row-standardized symmetric four-nearest-neighbor spatial weights matrix and included Global Moran’s I, bivariate spatial analysis, Local Indicators of Spatial Association, ordinary least squares, …

Implementing A Routine Fall Risk Assessment In Older Adults In An Inpatient Psychiatric Setting, Amaka Obi

Walden Dissertations and Doctoral Studies

The purpose of the project was to implement and evaluate a structured fall risk assessment process that promoted the early identification of patients at increased risk for falls and supported interventions designed to prevent fall-related events. A pre- and post-implementation evaluation design was used to assess the intervention's effectiveness by comparing fall rates before and after implementation of the standardized assessment protocol. De-identified data obtained from the electronic health record (EHR) were analyzed using descriptive statistics to evaluate changes in fall incidence and protocol adherence. The project findings demonstrated that provider-led, standardized fall-risk assessments improved screening compliance, provider adherence, and …

Comparison Between The Tooth Coronal Index And Kvaal’S Method In Age Estimation In The Indonesian Population, Astika Swastirani, Nabilah Shafiyyah Rahmayati, Sari Kurniawati, Ferdy Jonathan Walelang

Journal of Dentistry Indonesia

Background: Age estimation in adults is important in forensic odontology, and radiographic approaches such as the Tooth Coronal Index (TCI) and Kvaal's method are commonly applied to panoramic radiographs. This study aimed to compare the agreement of TCI and Kvaal age estimates with chronological age in adults.

Methods: This cross-sectional analytic study evaluated 100 panoramic radiographs (50 males, 50 females) of adults aged 23–45 years. Measurements were performed on mandibular first premolars using ImageJ. Accuracy was operationalized as the closeness of the estimated age to the chronological age and assessed using mean differences and Wilcoxon signed-rank tests.

Results …

Morphometric Evaluation Of The Styloid Process Using Cone-Beam Ct In A Central Anatolian Population, Melda Misirlioglu, Aslı Atacan Aslan

Journal of Dentistry Indonesia

Background: Accurate evaluation of craniofacial anatomy is essential for diagnostic planning. Variations of the styloid process (SP) provide anatomical data that guide evidence-based clinical and surgical decisions in the head and neck region.

Methods: Retrospective cone-beam computed tomography (CBCT) scans retrieved from the Department of Oral and Maxillofacial Radiology were examined. SP length, medial angles, calcification patterns, and the radiomorphometric index were assessed.

Results: Middle-aged adults represented the majority of the sample. Gender had a statistically significant effect on SP morphology Type 1 was the most common bilaterally, followed by Type 2. Calcification patterns varied between genders …

Clinical Outcomes Of Adjunctive Use Of Oxygen-Releasing Formula In Non-Surgical Treatment Of Periodontal Abscess Associated With Type 2 Diabetes Mellitus, Anil Kumar Kanakamedala, Laxmi Kavya Gangireddy, Gautami S Penmetsa, Sruthima Gottumukkala, Mohan Kumar Pasupuleti, Konathala Santhosh Venkata Ramesh

Journal of Dentistry Indonesia

Background: This study aimed to evaluate the effectiveness of oxygen-releasing formula (ORF) as an adjunct in the non-surgical management of periodontal abscess in patients with type 2 diabetes mellitus.

Methods: This split-mouth clinical trial was conducted on 14 patients with periodontal abscess with type 2 diabetes mellitus (T2DM), who were divided into a control group, nonsurgical periodontal therapy (NSPT) alone, and a test group (NSPT+ORF). Parameters such as Landry's healing index (HI) were evaluated at 1 week, 2 weeks, and 1 month. Probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing presence or absence (BOP) …

Diode Laser And Conventional Ferric Sulfate Pulpotomy In Deciduous Molars: Comparative Outcomes In Myanmar Children, Moe Myat Noe Phyu Dr, Ei Ei Myo, Soe Naing

Journal of Dentistry Indonesia

Background: Pulpotomy is a widely accepted treatment for carious exposure of vital primary molars, using various medicaments. Currently, lasers have emerged as a non-pharmacologic pulpotomy technique. However, comparative clinical studies in Myanmar remain limited. This study aimed to compare the effectiveness of diode laser and conventional ferric sulfate pulpotomy in deciduous molars among children in Myanmar.

Methods: A total of 40 deciduous mandibular molars requiring pulpotomy treatment were selected from children between 4 and 8 years of age. The subjects were randomly assigned to the diode laser group (Group A) or the ferric sulfate group (Group B) using …

The Association Between Hypodontia, Supernumerary Teeth, Cleft Type, And Cleft Side In Pediatric Non-Syndromic Cleft Patients In Malaysia, Tan Hwa En, Mohammad Majduddin Sulaiman, Norsamsu Arni Samsudin, Nurhafizah Ghani

Journal of Dentistry Indonesia

Background: Cleft lip and palate are the fourth most common congenital facial anomalies worldwide. Cleft patients have a higher prevalence of dental anomalies than the general population. This study aimed to evaluate the prevalence of hypodontia and supernumerary teeth among the permanent teeth of pediatric patients with clefts at Hospital Pakar Universiti Sains Malaysia (USM).

Methods: A retrospective record review study was conducted using dental records and panoramic radiographs from 64 non-syndromic cleft patients aged 6 to 17 years who attended Hospital Pakar USM between 2019 and 2024. Inter-examiner reliability for the assessment of hypodontia was strong, with …

Psychosocial And Functional Impact Of Temporomandibular Disorder Subtypes Among Adults: A Cross-Sectional Study In Indonesia, Ni Luh Dewi, Wita Anggraini, Maria Valiente-Lopez, Carolina Marpaung

Journal of Dentistry Indonesia

Background: Temporomandibular disorders (TMDs) affect psychological, functional, and pain-related aspects of oral health-related quality of life (OHRQoL). However, the differential impact of pain-related and non-pain-related TMDs remains limited. This study aimed to evaluate the impact of different TMD subtypes on psychological distress, jaw function, and OHRQoL in young adults and to determine whether pain-related TMDs exert a greater effect than non-pain-related TMDs.

Methods: In this cross-sectional study, 278 university students (aged 18–24 years) were categorized into no TMD (NT), pain-related TMD (PT), intra-articular TMD (IT), and combined TMD (CT). Diagnoses were made using the 5Ts Questionnaire screening tool …

Adverse Drug Reaction Reporting In Dental Practice And The Importance Of Pharmacovigilance In Dental Education, Radhakrishna Lagishetty, Lakshmi Ramya T, Kvr Barath Raju, Mohan Kumar Pasupuleti

Journal of Dentistry Indonesia

Background: Adverse drug reactions (ADRs) are a critical component of patient safety; however, ADR monitoring remains underutilized in dentistry. This study aimed to assess knowledge, attitudes, and practices regarding ADR reporting among undergraduate and postgraduate students and practicing dentists.

Methods: A cross-sectional observational study was conducted using a structured, validated 19-item questionnaire covering socio-demographics, knowledge (6 items), attitude (4 items), and practice (5 items), which was distributed both in person and online. A total of 258 complete responses were analyzed out of 300 individuals contacted (response rate: 86%). Descriptive statistics and Chi-square tests were applied, with p < 0.05 considered statistically significant.

Results …

Investigation Of Patients' Use Of Non-Pharmacological Substances In Dental Pain Management, Neslihan Yılmaz Çırakoğlu, Özgenur Kaya

Journal of Dentistry Indonesia

Background: Dental pain is a complex condition influenced by biological, biochemical, environmental, and psychological factors. Before seeking professional care, many patients attempt to relieve dental pain using self-administered, non-medical agents. This study aimed to investigate patients’ use of non-pharmacological substances in dental pain management and to identify factors influencing these practices.

Methods: The questionnaire consisted of four sections addressing demographic characteristics, oral hygiene habits, pain characteristics, and pain-relief agents. Categorical variables were analyzed using Pearson’s chi-square test. Categorical data are presented as frequencies and percentages, while continuous data are expressed as mean ± standard deviation and median values. …

Flaxseed Ethanolic Extract Modulates Β-Catenin And Dkk1 Expressions During Osteoblast Differentiation Of Dental Pulp-Derived Stem Cells, Nur Sazwi Nordin, Khairani Idah Mokhtar, Omar Abdul Jabbar Abdul Qader, Basma Ezzat Mustafa, Widya Lestari, Deny Susanti Darnis, Thirumulu Ponnuraj Kannan, Azlina Ahmad, Solachuddin Jauhari Arief Ichwan

Journal of Dentistry Indonesia

Background: WNT signaling regulates osteogenic differentiation of mesenchymal stem cells (MSC) through the canonical WNT pathway. β-catenin; an important molecule of WNT pathway, and DKK1; a WNT antagonist, play important roles in regulating bone formation. Although flaxseed (Linum usitatissimum) has various health benefits, including promoting bone health, our previous study showed that flaxseed ethanolic extract (FEE) reduced the osteoblast differentiation potential of stem cells from human exfoliated deciduous teeth (SHED). This study aimed to determine the effects of FEE on WNT pathway-related molecules, β-catenin and DKK1, during osteoblast differentiation of SHED.

Methods: RNA at Day 7, 14, …

Orthodontic Camouflage Treatment Of A Severe Class Iii Skeletal Pattern With Anterior Open Bite: A Case Report, Dikeledi Maureen Letsholo, Mandla Dominic Nyakale, Mosimane Peter Silas Sethusa

Journal of Dentistry Indonesia

Background: Class III malocclusion combined with anterior open bite (AOB) is one of the most challenging occlusal problems to treat. The objective of this article was to report a case of an adult female patient diagnosed with Class III malocclusion combined with an anterior open bite and a hyperdivergent facial pattern.

Case Report: Camouflage orthodontic treatment with the extraction of maxillary and mandibular first premolars was used to treat the patient. Anterior teeth were retracted maximally against the Nance holding arch and fixed lingual arch appliances, and box elastics were used to close AOB. At the end of …

The Correlation Between Medication Adherence, Blood Glucose Levels, And Quality Of Life In Patients With Type 2 Diabetes Mellitus At Ciamis Regional Hospital, Amyla Putri Nurul Nazmi, Nur Rahayuningsih, Lusi N

Pharmacology and Clinical Pharmacy Research

Type 2 diabetes mellitus is a chronic condition requiring continuous treatment, including patient adherence to prescribed medication. This study aimed to explore the relationship between medication adherence, blood glucose levels, and quality of life in patients with type 2 diabetes mellitus at Ciamis Regional Hospital, conducted from January to March 2025, the research employed a quantitative, prospective cross-sectional design involving 49 hospitalized patients. Data included blood glucose levels (RPG, FPG, 2hPG), medication adherence measured using the Medication Adherence Report Scale (MARS-5), and quality of life assessed via the Diabetes Quality of Life-Brief Clinical Inventory (DQOL-BCI). The chi-square test was used …

The Phytochemical Content And Antibacterial Activity Of Purified Extract Of Mangifera Indica L. Against Gram Positive Pathogen, Dewi Andini Kunti Mulangsri, Masduki Faqih, Sugar Arifin, Mutiara Trie Sieya Agustin

Pharmacology and Clinical Pharmacy Research

The purified extract of arum manis mango leaves contained flavonoid compounds by TLC methods and antibacterial activity against Gram-positive and negative pathogens. This research aimed to identify and determine the phytochemical content (mangiferin and flavonoids content) and antibacterial activity against other Gram-positive pathogens. Purification of ethanol extract of arum manis mango leaves by liquid-liquid fraction method. Determination of total flavonoid content and identification of mangiferin used respectively by aluminum chloride and Thin Layer Chromatography method. The disk diffusion method was used to assay antibacterial activity against S. epidermidis, and B. subtilis bacteria with the concentration of the sample such …

Cost Effectiveness Analysis Of Psychopharmaca Therapy Combination Compared With Psychopharmaca Therapy And Ect Combination In Schizoaffective Inpatients At The Rsj Provinsi Jawa Barat, Yasmin Fadillah, Sani Asmi Ramdani Lestari, Ardilla Kemala Dewi

Pharmacology and Clinical Pharmacy Research

Mental disorders constitute an economic burden on health, estimated at USD 2.5 trillion in 2010 and expected to increase to USD 6 trillion by 2030. Treatment of schizoaffective disorder involves a combination of medication and psychotherapy. Pharmacoeconomics is an important consideration in drug selection. This study aims to determine the cost-effectiveness of psychopharmaca therapy combination compared with psychopharmaca therapy and ECT combination in schizoaffective inpatients at the RSJ Provinsi Jawa Barat. Data collection was conducted retrospectively from patient medical records for the period December 2023–December 2024. Total costs, based on a health perspective, include psychopharmaca drug costs, inpatient care costs, …