Medicine and Health Sciences Commons^™

Evaluating The Impact Of System, Information, And Service Quality On User Outcomes In Malaysian Public Hospitals: A Structural Equation Modeling Approach, Muhd Siv Azhar Merican Abdullah, Azimatun Noor Aizuddin, Mohd Rizal Abdul Manaf

Makara Journal of Health Research

Background: Increasing use of hospital information systems (HIS) underscores the need to evaluate their impact on User Satisfaction and Perceived Net Benefits. This study investigated the connections among outsourced System Quality, Information Quality, Service Quality, Perceived Usefulness, User Satisfaction, and Perceived Net Benefits in the context of Malaysian public hospitals.

Methods: Data were collected from 1,376 healthcare personnel across six public hospitals and analyzed using structural equation modeling through analysis of moment structures grounded in the DeLone and McLean Information Systems Success Model.

Results: System and Service Qualities significantly influenced User Satisfaction and Perceived Usefulness, while Information Quality impacted …

A Cross-Sectional Study On Patient Safety Attitudes And Their Determinants Among Medical Staff In Malaysian Public Specialist Hospitals, Sharifah Balqis Sayed Abdul Hamid, Aniza Ismail, Saperi Sulong

Makara Journal of Health Research

Introduction: This study aimed to assess the baseline level and mean scores of patient safety attitude domains among doctors and nurses in Malaysian public hospitals and to identify determinants associated with these attitudes across six domains: teamwork, safety climate, working conditions, job satisfaction, stress recognition, and perception of management.

Methods: A cross-sectional study was conducted using the Safety Attitudes Questionnaire (SAQ) among 142 doctors and 231 nurses from three public tertiary hospitals. Participants were selected through proportionate stratified random sampling. Data were analyzed using descriptive, bivariate, and multivariate methods.

Results: The study achieved an 81% response rate. …

Exploring The Prevalence And Determinants Of Self-Medication During Pregnancy Among Women From South Punjab, Pakistan, Madiha Madiha, Sehar Jabbar, Imran Masood

Makara Journal of Health Research

Background: For developing countries with high neonatal and maternal mortality rates, any practice that may threaten the maternal-fetal health must be gauged. This study evaluated the prevalence and contributing factors of self-medication during pregnancy among women opting for antenatal or postnatal care in South Punjab, Pakistan.

Methods: A cross-sectional study design was used. Data was collected from 424 women, selected through multi-stage sampling, who visited health care facilities located in six randomly selected cities of South Punjab. Outcomes reported by descriptive and inferential statistics (p < 0.05). Binary logistic regression analysis was performed to determine the association of self-medication with different factors.

Results: Most of the women were involved in self-medication practice (38.9%) …

The Relationship Between Religious Attitude And Breastfeeding Attitude: A Cross-Sectional Study From Türkiye, Melike Yavaş Çelik, Cuma Tunçkaşık

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: This study was conducted with 203 mothers with babies aged 0–24 months. Simple random sampling was used in sample selection. The Religious Attitude Scale and Breastfeeding Attitudes of the Evaluation Scale were used in data collection.

Results: A significant relationship was found between religious attitudes and breastfeeding attitudes. Additionally, mothers' negative breastfeeding attitudes and positive breastfeeding attitudes were found to be close to each other. The time it took for mothers to start breastfeeding their …

Current Insight Into Ldlr And Pcsk9 Genetic Variants: Investigating Genetic Keys To Cholesterol In A Cohort Of Stroke Patients From Yogyakarta, Indonesia, Loury Priskila, Lenggana Relung Atmadi, Arya Taksya Bagaskara, Andreas Mercyan Anggitama

Makara Journal of Health Research

Background: Stroke is the second leading cause of mortality worldwide. In Yogyakarta, Indonesia, the incidence of stroke (14%) is higher than the national average. We therefore investigated the roles of LDLR rs688 (C/T) and PCSK9 rs562565 (A/G) polymorphisms in familial hypercholesterolemia as predictors of first-time ischemic stroke.

Methods: In this case-control study, 119 first-time ischemic stroke patients were divided into dyslipidemia (N = 71) and non-dyslipidemia groups (N = 48). The DNA of the nucleotide polymorphisms LDLR rs688 (C/T) and PCSK9 rs562556 (A/G) was extracted and analyzed using the PCR-RFLP method, and statistical analyses were performed to evaluate …

Knowledge, Attitudes, And Practices Concerning Water, Sanitation, And Hygiene And Related Diseases Among University Students In Malaysia, Renee Ng Jeffrey, Aida Soraya Shamsuddin, Farah Diyana Ariffin, Aziemah Zulkifli

Makara Journal of Health Research

Background: Water, sanitation, and hygiene (WASH) practices are fundamental components of public health, being crucial in preventing disease transmission and promoting healthy living environments. In this context, university students play an essential role as future professionals and community advocates in fostering proper hygiene behaviors and preventing disease outbreaks. Understanding knowledge, attitudes, and practices (KAP) in regard to WASH among individuals, particularly university students, is crucial for promoting proper hygiene behaviors. This study aimed to assess the KAP in regard to WASH and related diseases among undergraduate students from the Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM).

Methods: …

Climate Change Anxiety Related To Women’S Health Among Health Sciences Students, Derya Kaya Şenol, Semiha Aydın Özkan, Durdu Cennet Omuş

Makara Journal of Health Research

Background: Climate change impacts are unequally distributed globally, with children, women, pregnant women, the elderly, marginalized populations, and refugees bearing a disproportionate burden. This study aims to determine the levels of related anxiety among female students and to examine the relationship between the anxiety and their perceptions, knowledge levels, and health behaviors related to women’s health.

Methods: The study has a descriptive cross-sectional design. The study population included women students enrolled in the fall semester of the 2023–2024 academic year at the Faculty of Health Sciences of a university between October and December 2023. Personal Information Form and …

Moving Toward Healthy Ageing: The Role Of Physical Activity In Cognitive Function And Self-Esteem Among Older Adults In Türkiye, Canan Birimoglu Okuyan, Müjde Kerkez

Makara Journal of Health Research

Background: This study aimed to evaluate the relationship between religious attitudes and breastfeeding attitudes and the effect of this relationship on breastfeeding practices.

Methods: A cross-sectional study was conducted with 251 older adults. Data were collected using the International Physical Activity Questionnaire, the Standardized Mini-Mental State Examination, and the Rosenberg Self-Esteem Scale. Spearman’s correlation and chi-square tests were employed for statistical analysis.

Results: Physical activity levels were positively correlated with both cognitive function (r = 0.546, p < 0.001) and self-esteem (r = 0.168, p < 0.05). No significant association was observed between cognitive function and self-esteem. Physical inactivity, cognitive decline, and low self-esteem were more prevalent among women, participants with lower educational attainment, those with chronic diseases, and individuals engaged in polypharmacy.

Conclusions: The findings emphasize the importance of integrating physical activity promotion into national healthy ageing policies, particularly in Mediterranean contexts such …

The Relationship Between Individual Innovativeness Traits And Medical Artificial Intelligence Readiness Levels Among Nursing Students In Türkiye, Özlem Öztürk, Tülay Sağkal Midilli

Makara Journal of Health Research

Background: This study examined the relationship between nursing students’ individual innovativeness traits and their readiness for medical artificial intelligence, and the influencing factors.

Methods: This study was a descriptive, correlational study. The study was conducted with 606 nursing students enrolled at the Faculty of Health Science, Manisa Celal Bayar University. Data were collected using the Descriptive Information Form, the Individual Innovativeness Scale (IIS), and the Medical Artificial Intelligence Readiness Scale (MAIRS).

Results: The mean IIS score was 64.23 ± 8.47, indicating that most students fell into the skeptical or interrogator categories. The mean MAIRS score was 75.77 …

Protocols For Antioxidant Testing: A Mini Review Of Common Assays And Approaches, Abdulsalam Halboup, Sameer A. Alkubati

AUIQ Complementary Biological System

Antioxidants play a pivotal role in mitigating damage caused by oxidative stress, which is implicated in aging, inflammation, neurodegeneration, and various chronic diseases. With the growing interest in natural and synthetic antioxidants across nutraceutical, pharmaceutical, and food industries, the need for reliable, reproducible, and standardized testing methods has become increasingly urgent. This mini-review provides a structured overview of the most widely used antioxidant testing protocols, categorized into in vitro chemical-based assays (e.g., DPPH, ABTS, FRAP, metal chelation), cell-based assays (e.g., DCFH-DA for intracellular ROS detection), and in vivo biomarker-based models. Each method’s principle, experimental protocol, advantages, and limitations are critically …

Prevalence Of Giardia Infection: A Cross-Sectional Study In Basra Province, Iraq, Sarah Kamal Naser

AUIQ Complementary Biological System

Giardiasis is a common parasite infection that is seen more frequently than any other parasitic infection worldwide. This infection is especially prevalent in tropical areas and in developing nations that have a poor standard of living and poor health conditions. The Giardia parasite is able to infect people of any gender, as it enters the body by the mouth, passes down the oesophagus, and finally reaches the stomach, where it is not negatively impacted by gastric acids. The goal of this study is to determine the extent to which patients who were treated at Al-Zubair General Hospital in Basra, Iraq, …

From Plaque To Tumour: Follicular Neoplasm Arising In Congenital Nevus Sebaceous, Tasneem Hamed Al Salmani, Suad Al Jahdhami, Nawaf Al Muqaimi, Ayida Al Khalili

Sultan Qaboos University Medical Journal

No abstract provided.

Prevention Of Suicide As Perceived By Educated Adults In Ondo Metropolis, Ondo State, Nigeria, Margaret Kehinde Soetan

Buletin Konseling Inovatif

This study investigated prevention of suicide as perceived by educated adults in Ondo metropolis, Ondo State, Nigeria. Descriptive survey research design was adopted for this study. Population of the study consisted of all educated adults in Ondo metropolis, Ondo State. The sample comprised two hundred (200) educated adults randomly selected from the metropolis. Structured questionnaire was used as instrument to collect data for the study. Data collected was analysed using mean, ranking, t-test and analysis of variance (ANOVA). The results revealed the perception of prevention of suicide as giving people hope for a better life after current problems are resolved, …

Health Implications Of Heavy Metal Contamination In Commercially Available Deodorant And Antiperspirant Products Sold In Benghazi, Libya, Maysson Yaghi, Khaled Elsherif

Al-Bahir

The extensive usage of deodorants and antiperspirants raises concerns about the potential health risks posed by heavy metal content. This study quantified the levels of five heavy metals: Aluminum, Zirconium, Lead, Cadmium, and Chromium in 22 commercial products widely used in Benghazi, Libya, and assessed the associated health risks. Samples, categorized into gel, stick, and roll-on formulations, were analyzed using iCAP TQ ICP-MS. Al and Zr showed the widest concentration ranges, reflecting their intentional use as active ingredients. Al levels ranged from trace amounts (0.032 mg/kg) up to a maximum of 99.10 mg/kg, while Zr was found exclusively in gel …

Takotsubo Cardiomyopathy In A 55-Year-Old Female With Atypical Chest Pain And A History Of Autoimmune Disease, Carrie Greene, Dana Mathew

Florida Journal of Emergency Medicine (FJEM)

A 55-year-old woman with rheumatoid arthritis and supraventricular tachycardia presented with acute chest pain radiating to the back/left shoulder, with nausea and lightheadedness. Initial ECG showed inferior–lateral ST-segment elevation with reciprocal depressions; within 90 minutes the STE resolved with new incomplete RBBB and diffuse low voltage. High-sensitivity troponin rose (delta ~270 ng/L). Point-of-care and formal echocardiography revealed LV wall-motion abnormalities. Emergent catheterization showed no obstructive CAD (<30% distal OM) with apical ballooning and EF 40–45%, consistent with Takotsubo cardiomyopathy; cardiac MRI confirmed myocardial edema. She was managed with anticoagulation initially, telemetry, and supportive care, and recovered uneventfully with normalization of function on follow-up.

ED Takeaways

• TTC can mimic STEMI with transient STE and conduction changes.

• Troponin rise + non-obstructive coronaries should prompt consideration of TTC.

• Consider TTC in post-menopausal women and those with autoimmune disease; use …

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Meningococcemia In Boy With Dense Deposit Disease Receiving C5 Complement Inhibitor Ravulizumab, Andrew Gonedes, Alexandra Martinez, Allan M. Greissman, Hanan Atia, Eric Boccio

Florida Journal of Emergency Medicine (FJEM)

No abstract provided.

Complete Atrioventricular Block In A Heart Transplant Recipient, Jalyn Joseph, Morgan Reel, Eric Boccio

Florida Journal of Emergency Medicine (FJEM)

Complete atrioventricular (AV) block, though uncommon in heart transplant recipients, is a potentially life-threatening condition that demands rapid diagnosis and management in the acute care setting. During complete AV block, there is a failure of electrical conduction from the atria to the ventricles resulting in the independent and dyssynchronous contraction of the heart chambers. Due to the resultant decrease in cardiac output, patients may experience lightheadedness, fatigue, shortness of breath, syncope and near syncope, and, in severe cases, cardiogenic shock may develop. A 58-year-old female with past medical history including hypertension, diabetes, chronic kidney disease, and congestive heart failure and …

Distinguishing Acute Cardiac Events From Chronic Troponin Elevation: Integrating High-Sensitivity Troponin Trends With Objective Ischemic Evidence Under The 4th Udmi Across Diverse Renal Function Profiles, Aidan Fernandez, Amanda Green, Silvija Milanovic, Eric Han, Asia Elbooz, Michael Petrauskis, Justin Nippert, Michael Marchick, Nicholas Maldonado, Mohammed Ruzieh, Elizabeth Warren, Matthew Shaw, Lars Beattie, Brandon Allen

Florida Journal of Emergency Medicine (FJEM)

The Fourth (4th) Universal Definition of Myocardial Infarction (UDMI) provides a standardized framework to enhance diagnostic accuracy and clinical decision-making. However, challenges can arise due to the use of subjective clinical assessment in diagnostic criteria or in the presence of impaired renal clearance. This study modifies the 4th UDMI by requiring objective ischemic evidence to improve consistency in myocardial infarction (MI) classification and applies it across diverse patient populations.

In this retrospective study, patients who presented to the emergency department (ED) with 99th percentile high sensitivity cardiac troponin (hs-cTn) values were classified using the modified 4th UDMI into the categories …

Unexpected Companions: Appendicitis And Bilateral Testicular Torsion, Jc Alvarenga, Melissa Kirk, Michelle Osorio-Rodriguez

Florida Journal of Emergency Medicine (FJEM)

Abdominal pain is a frequent chief complaint in the emergency department (ED), responsible for 5% of all visits yearly. Despite emergency room work ups, 25% of these cases go undiagnosed. In the pediatric population, abdominal pain can be even harder to differentiate with causes ranging from low acuity constipation to emergent surgical emergencies like torsion or appendicitis. During these visits, the likelihood of two emergent surgical diagnoses occurring concurrently is a rare and often overlooked occurrence.

This case describes a 15-year-old male with a chief complaint of nausea and vomiting starting several hours prior to arrival. In the ED, history, …

Acquired Methemoglobinemia Secondary To Oral Ingestion Of Alkyl Nitrite, Larissa L. Tavares, David Neff, Christopher Didonato, Atul Sofat, Eric Boccio

Florida Journal of Emergency Medicine (FJEM)

Methemoglobinemia is a potentially life-threatening condition in which the ferric state of hemoglobin impairs oxygen transport, leading to refractory hypoxia. While most cases are acquired through exposure to oxidizing agents, this report details a rare case of acquired methemoglobinemia complicated by severe hypotension and pulmonary edema secondary to the oral ingestion of alkyl nitrite, colloquially known as a “popper.”

A 54-year-old male presented to the emergency department after orally ingesting an alkyl nitrite product, believing it would be more effective than inhalation. Shortly after, he developed dizziness, dyspnea, and dusky skin, and was found to be hypotensive and hypoxic. Initial …

Disaster Exercise: Evaluating Mci Triage Training, Michael J. Steflovich Jr, Jodie Stobierski, Alexis Davis, Natasha Pavlinetz, Nela Isic, Nicole Roberson, Earl Best Md

Florida Journal of Emergency Medicine (FJEM)

Abstract

Study Objectives

The primary objective of this study was to evaluate the effectiveness of a didactic lecture-based training on mass casualty incident (MCI) triage performance among first- and second-year medical students. Specifically, the study aimed to measure improvements in overall triage accuracy, as well as reductions in over-triage and under-triage rates for both adult and pediatric patients.

Methods

This study employed a pre-test/post-test design involving 31 participants. Participants completed an electronic pre-test consisting of 30 patient scenarios (20 adult and 10 pediatric) before attending a 40-minute didactic lecture on MCI triage principles. The lecture covered the identification of MCI …

Point Of Care Ultrasound For Rapid Identification Of Central Retinal Artery Occlusion And Subsequent Vision Rescue Utilizing Intravenous Alteplase, Joseph Pepe, Karl Kasischke, Calen Hart

Florida Journal of Emergency Medicine (FJEM)

Central retinal artery occlusion (CRAO) is a rare but critical diagnosis to make in patients with acute vision loss. Cases of central retinal artery occlusion historically have a poor prognosis due to delayed presentation, lack of early identification, and limited effective treatment options. Due to these challenges, patients are often left with permanent loss of vision.

We present a case of a male patient in his late 70s with sudden onset of loss of vision to the right eye. Identification of CRAO was made utilizing point of care ultrasound (POCUS). After discussion with neurology, the patient was treated with alteplase …

Hemiballismus Secondary To Acute Cerebrovascular Accident, Benjamin Duppstadt, Andres Vega, Jonathan Hill, David Arbona

Florida Journal of Emergency Medicine (FJEM)

Hemiballismus is a rare hyperkinetic movement disorder characterized by involuntary, large amplitude flinging movements. We present the case of a 61-year-old male with multiple comorbidities who arrived at the emergency department with acute-onset hemiballismus of the left upper extremity, ultimately found to be secondary to a right middle cerebral artery (MCA) infarct. This case underscores the importance of considering stroke in the differential for new-onset movement disorders, even in patients with seemingly psychiatric features and a nondiagnostic initial computed tomography (CT) scan.

Ultrasound-Guided Needle Aspiration Of A Peritonsillar Abscess In The Emergency Department, Elizabeth Piwowarski, Kenith Dsouza, Taryn Hoffman

Florida Journal of Emergency Medicine (FJEM)

Background

Peritonsillar abscess (PTA) is a relatively common diagnosis to encounter in the emergency department (ED). If untreated, PTA can lead to serious outcomes such as airway compromise, deep space infections and septicemia. Point of care ultrasound (POCUS) can be used by the emergency physician to confirm the suspected diagnosis, evaluate the size and depth of the abscess, and be used as a guide during needle aspiration.

Case

A 26-year-old male presented to the ED with a sore throat and was found to have a peritonsillar abscess on exam, which was confirmed using computerized tomography (CT) imaging. Providers were unable …

When Clotting And Bleeding Collide: A Case Of Bilateral Pe And Concurrent Upper Gi Hemorrhage, Tabitha D. Baca, David Rayburn, Daniel Castro, Jessica Aird

Florida Journal of Emergency Medicine (FJEM)

Introduction

Concurrent episodes of pulmonary emboli and gastrointestinal bleeding in one patient are not commonly seen. When a patient presents with both, it presents a challenge to manage as they are opposite ends of the same disease spectrum associated with the coagulation system.

Case Report

We present the case of a 65-year-old male who presented to our hospital via EMS with unknown prior history after a witnessed cardiac arrest, who on evaluation also had a concurrent bilateral pulmonary emboli with right heart strain.

Why should an emergency physician be aware of this?

While there is extensive research on the management …

Pilot For A Virtual Regional Ophthalmic Health Disparities Journal Club For Pre-Medical And Medical Students: A Three-Year Analysis, Bridget Croniger, Ariane Kaplan, Anjali R. Shah, Chaesik Kim, Rachel Riddle, Tannia M. Rodriguez, Anju Goyal

Journal of Academic Ophthalmology

Background: Social determinants of health influence ophthalmic health outcomes in the United States. Understanding these factors is crucial for current and future physicians, but there is no standardized curriculum to teach learners about this topic.

Purpose: This pilot study evaluated the impact of three virtual regional ophthalmic health disparities journal clubs on pre-medical and medical students’ understanding of ophthalmic health disparities, interest in ophthalmology, and comfort in appraising medical literature.

Methods: Three annual virtual journal clubs were held in 2022, 2023, and 2024. Each session featured a different peer-reviewed published article related to ophthalmic health disparities as well …

Pilot And One-Year Follow-Up Of A Novel Hybrid Ophthalmology Elective Course For Preclinical Students, Amina Avril, Jason J. Jo, Jessica Tran, Claire Ufongene, Samira Farouk, Nisha Chadha

Journal of Academic Ophthalmology

Background: Preclinical elective courses, particularly in a hybrid format, may facilitate ease of access, increase exposure, and build interest in ophthalmology.

Purpose: To evaluate knowledge acquisition and interest in ophthalmology immediately after and 1 year after implementing a novel elective course.

Methods: We developed an optional, 8-session, hybrid elective course based on the American Academy of Ophthalmology objectives for medical students. The course included virtual didactics and in-person skills sessions. Each virtual session focused on an ophthalmic subspecialty and consisted of a facilitated case review followed by an interactive career-related discussion with a faculty member practicing that …

In Recent Research: Exosomal And Molecular Regulators Of Browning And Thermogenesis In Adipose Tissues, Merve İnel, Bahadir Öztürk

Turkish Journal of Medical Sciences

This review synthesizes current knowledge on the molecular mechanisms regulating brown, white, and beige adipose tissues, with particular emphasis on the browning process of white adipose tissue. Rather than considering adipose tissue as a passive energy reservoir, this review underscores its active role as a dynamic endocrine and metabolic organ. Brown and beige adipose tissues, recognized for their thermogenic capacity and contribution to energy expenditure, have emerged as promising therapeutic targets for the treatment of obesity, type 2 diabetes, and related metabolic disorders. The review draws upon recent findings on adrenergic signaling, transcription factors, exosomal microRNAs, and other novel regulatory …

Telemedicine Versus Conventional Care For Nonspecific Neck Pain: A Randomized Controlled Study, Selki̇n Yilmaz Muluk, Sevtap Badil Güloğlu, Begüm Ünlütaşkiran

Turkish Journal of Medical Sciences

Background/aim: Telemedicine (TM) can overcome travel barriers in nonspecific neck pain (NNP), yet a comprehensive, physiatrist-supervised TM model has not been directly compared to standard in-clinic care. The aim of this study was to determine whether a video-based exercise and remote follow-up program is as effective as conventional follow-up in reducing pain and disability in NNP.

Materials and methods: This parallel-group randomized controlled trial (registered in ClinicalTrials.gov) included 68 adults (mean age = 40.52 years) with NNP who were randomly allocated 1:1 to the TM group (TG, n = 34) or control group (CG, n = 34). Both received identical …

The Impact Of Hypophosphatemia On Biochemical Profile And Renal Outcomes In Primary Hyperparathyroidism: A Nationwide Retrospective Study, Nai̇m Ata, Beki̇r Uçan, Hali̇l Durantaş, Oğulcan Boz, Mustafa Şahi̇n, Mustafa Mahi̇r Ülgü, Şuayi̇p Bi̇ri̇nci̇, Muhammed Kizilgül

Turkish Journal of Medical Sciences

Background/aim: Although low phosphorus (P) concentrations are a recognized feature of primary hyperparathyroidism (PHPT), they are not among the diagnostic or surgical criteria. The present study evaluates the association between serum phosphorus levels and clinical outcomes in PHPT patients.

Materials and methods: A search of the Turkish Ministry of Health’s National Electronic Database was conducted using ICD-10 diagnostic codes and laboratory data to identify PHPT cases within the Turkish population from 2017 to 2022.

Results: The records of a total of 113,330 PHPT patients (77.5% female; mean age 58.9 ± 15.6 years) were analyzed, revealing a mean serum phosphorus level …