Medicine and Health Sciences Commons^™

External Multicenter Validation Of The Esah Score For Predicting Outcomes After Subarachnoid Hemorrhage, Natália Vasconcellos De Oliveira Souza, Rohan Sharma, Otavio Frederico De Toledo, Ingrid Pereira Marques, Salvador F. Gutierrez-Aguirre, Lara-Velazquez Montserrat, Eric Sauvageau, Naval Neeraj, Amin Aghaebrahim, Feres Chaddad Neto, Ricardo A. Hanel, Gisele Sampaio Silva, William David Freeman

Jefferson Hospital Staff Papers and Presentations

Reliable assessment of prognosis after aneurysmal subarachnoid hemorrhage (SAH) is essential to inform clinical decision-making and prevent premature assumptions of poor outcome. The enhanced SAH (eSAH) score combines three routinely available variables-age, Glasgow Coma Scale (GCS), and subarachnoid hemorrhage blood volume (SAHV)-to provide an objective framework for early outcome stratification. SAHV is estimated using the ABC/2-derived ellipsoid method applied across five major cisternal compartments on non-contrast CT. While the eSAH score has shown promise in initial derivation studies, its external performance and calibration have not yet been validated across diverse healthcare settings. We conducted a retrospective cohort study using consecutive …

Hypoplastic Left Heart Syndrome: Key Insights For Pediatricians, Michael Smith, Pezad Doctor

Pediatrics in Practice: A CME Podcast

Join Pezad Doctor, MD for a focused discussion on hypoplastic left heart syndrome (HLHS). Learn what pediatricians need to know about early detection, surgical stages, interstage monitoring, and supporting families through this complex journey. Practical tips and emerging updates will help you feel confident in managing HLHS in your practice.

Click here to stream the podcast episode.

A Novel Mathematical Model Of Hiv Transmission Incorporating The Effects Of Treatment And Pre-Exposure Prophylaxis: Sensitivity Analysis And Numerical Simulations, Erick Manuel Delgado Moya

Mathematical Modelling and Numerical Simulation with Applications

Human immunodeficiency virus (HIV) continues to be a public health problem in many countries of the world, and Pre-exposure prophylaxis (PrEP) is a preventive method for HIV, which has shown great efficacy and is in use worldwide. This work presents a new mathematical model for HIV transmission incorporating PrEP use and evaluates the impact of PrEP along with its increasing use in a population. The construction of the model takes into account three forms of diagnosis: diagnosis of individuals in risky sexual contact, diagnosis after risky contact (diagnosis in the undiagnosed infected compartment), and diagnosis associated with attempting to enter …

Cytomegalovirus As A Potential Trigger For Acute Coronary Syndrome: A Case Of Nstemi In A Previously Healthy Patient, Hussam Al Hennawi, Muhammad Sabri, David Teng, Maxwell Berman, Botros Shenoda

Abington Jefferson Health Papers

Cytomegalovirus (CMV) infection has been implicated in endothelial dysfunction and atherogenesis, yet its role as a potential trigger for acute coronary syndrome (ACS) remains underrecognized. We present a case of a 32-year-old male with no prior medical history who developed non-ST elevation myocardial infarction (NSTEMI) and was subsequently found to have active CMV infection. The patient had no known history cardiovascular disease, though subsequent testing did reveal additional underlying risk factors. This case highlights the need to consider infectious etiologies, including CMV, as contributors to ACS in young, otherwise apparently healthy individuals. Understanding the interplay between viral infections and atherosclerotic …

Health Risk Assessment (Hra) In Home-Based Ironing Businesses: Risk Identification, Intervention, And Evaluation In Johar Baru District, Central Jakarta, Heru Alfares, Irawadi Darmaputra, Marsen Isbayuputra, Muhammad Ilyas

Occupational and Environmental Medicine Journal of Indonesia

Background Home-based ironing businesses in Johar Baru District, Central Jakarta, are part of the informal sector, vulnerable to health risks due to suboptimal working conditions. This study aims to identify, assess, and control health risks through a Health Risk Assessment (HRA) approach.

Methods Research methods include direct observation, interviews, environmental measurements, health screenings, and ergonomic surveys using the BRIEF (Baseline Risk Identification of Ergonomic Factor) instrument.

Results The results indicate that the temperature in the ironing area reaches 33°C, exceeding the comfort standard, and that 80% of workers have dark yellow urine, indicating a high risk of dehydration. Risk assessment …

Returning To Work On Chef With Graves’ Disease: A Case Report, Izzatul Abadiyah, Dewi Sumaryani Soemarko

Occupational and Environmental Medicine Journal of Indonesia

Background Graves’ disease has adverse effects on quality of life, because of somatic psychiatric symptoms and an inability to work. Chefs face many occupational hazards that can aggravate certain medical conditions, worsen the disease, and pose safety risks at work. This case report aims to assess the returning-to-work evaluation and program for a chef with Graves’ disease.

Case Description A forty-seven-year-old Indonesian male who was diagnosed with Graves’ disease from characteristic clinical features and biochemical abnormalities was admitted to the hospital with shortness of breath. TSH concentration was 0.001mU/L, FT4 concentration was 2.85 ng/dL, hemoglobin level was 10.6 g/dL, and …

Burden Of Musculoskeletal Disorders, Associated Risk Factors And Perceptions On Prevention Among Airport Baggage Handlers, Ashish A. Trivedi Md, Alice Lai, Mahmud Tasim, Nik Tuah

Occupational and Environmental Medicine Journal of Indonesia

Background Airport baggage handlers are involved in manual handling of heavy loads, predisposing them to the risk of developing work-related musculoskeletal disorders (MSDs). This study aimed to determine the burden of self-reported MSDs and their associated factors among airport baggage handlers in Brunei Darussalam.

Methods In this cross-sectional study, we used a self-administered questionnaire to collect demographic and work profile data. We also incorporated the Nordic Musculoskeletal Questionnaire to assess body-part MSD symptoms over a 12-month period. Baggage handlers’ perceptions of the likelihood of specific work tasks related to MSDs and of preventative measures were also sought.  The data were …

Comparative Analysis Of Groundwater Quality Based On Chemical Parameters Around Final Disposal Sites Using Open Dumping And Sanitary Landfill Methods, Shiesil Rizqia Amadia, Mika Vernicia Humairo

Preventia: The Indonesian Journal of Public Health

The main environmental issue at landfill sites is the seepage of leachate into the ground, which contaminates surrounding aquifers. Communities residing within one kilometer of landfill sites are at high risk of environmental pollution. This study aimed to analyze differences in groundwater quality around landfills applying open dumping and sanitary landfill methods, and to compare groundwater quality at safe and unsafe distances from these sites. The research was conducted around the Cipayung landfill in Depok (open dumping) and the Talangagung landfill in Kepanjen (sanitary landfill). The study adopted an analytical observational approach using a cross-sectional design. The independent variables included …

Analysis Of Demand And Supply Of Radiotherapy Services At Dr.M.Djamil General Hospital Padang, Viola Shinta Dewi, Catur Suharinto, Zarni Zamzahar, Yulhaini Yulhaini

Preventia: The Indonesian Journal of Public Health

Around 10 million cases of cancer are discovered in the world per year, and it will continue to increase. Half of cancer cases require radiotherapy as treatment therapy. Dr. M. Djamil General Hospital, Padang, in 2021, has only 1 Cobalt radiotherapy. This study aimed to analyze the demand and supply of radiotherapy services at Dr. M. Djamil General Hospital, Padang. This descriptive study was conducted at Dr. M. Djamil General Hospital, Padang from May to December 2022. Data were analyzed using univariate analysis to describe the variables studied. This study reported that 241 patients were registered and received radiotherapy services. …

The Role Of Climate And Population Density In The Spread Of Dengue Fever: A Spatial Analysis Of Padang City 2022–2024, Nailul Hikmi, Aria Gusti

Preventia: The Indonesian Journal of Public Health

In 2023, Padang city had a dengue fever incidence rate of 46.5 per 100,000 population, an increase compared to the previous year. Climate change, with the transition from the dry to the rainy season, contributed to a surge in dengue fever cases. This study aims to determine the relationship between environmental factors and the incidence of dengue fever in Padang City from 2022 to 2024. This study uses an ecological study design with a sample of all dengue fever cases recorded by the Padang City Health Office. Climate data was obtained from the Indonesian Agency for Meteorological, Climatological, and Geophysical …

From Medical Check-Ups To Risk-Based Health Governance: Reframing Fitness-For-Work And Preventive Health In Modern Health Systems, Kasyunnil Kamal, Iqbal Mochtar

Occupational and Environmental Medicine Journal of Indonesia

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Green Tea (Camellia Sinensis) And Cognitive Health: A Systematic Review Of Mechanisms, Clinical Evidence, And Neuroprotective Potential, Elisha Rosalyn Rosdah, Eka Febri Zulissetiana, Irfannuddin Irfannuddin

Folia Medica Indonesiana

Cognitive decline, often a precursor to neurodegenerative diseases like Alzheimer's, is a growing global health challenge. Green tea (Camellia sinensis), rich in bioactive compounds such as epigallocatechin-3-gallate (EGCG) and L-theanine, has demonstrated promise in supporting cognitive function and reducing cognitive decline. This systematic review evaluated the recent evidence on the effects of green tea on cognition and its underlying mechanisms. The authors conducted a comprehensive search of PubMed, SpringerLink, and ScienceDirect for open-access articles published between January 2020 and April 2025. This systematic review included studies examining the impact of green tea on cognitive function in humans and …

The Impact Of Pasifikas In Medicine On Pacific Islander Medical Student Experiences, Devon Hori Harvey, Micah Ngatuvai, Siale Vaitohi, Paige E. Faasuamalie, Maegan Tupinio, Lisa H. Smith

Student Papers, Posters & Projects

BACKGROUND: Pacific Islanders experience significant health disparities. One contributing aspect to these disparities is the lack of racial concordance as Pacific Islanders are underrepresented in the U.S. physician work force. Several factors contribute to this underrepresentation including lack of support systems for Pacific Islander premed and medical students. Pasifikas in Medicine (PiM) is a recently established national student organization founded to provide support for Pacific Islander premed students, medical students, residents, fellows and attending physicians. This study seeks to understand the impact of PiM on medical student experiences.

METHODS: An anonymous survey was distributed to the PiM listserv and to …

Prevalence Of Psychological Distress Among Parents Of Children With Autism In Al-Diwaneyah Province/Iraq, Noor Abdulmahdi Alrabeeah, Abdulzahra Al-Khafaji

Al-Qadisiyah Medical Journal

Background: Families suffer from a lot of psychological pressure in accepting their child’s illness, especially if the disorders are affecting their mental and psychological development, such as autistic spectrum disorder. Aim: The study aimed to evaluate the extent of psychological distress among parents of children with autistic disorder and its association with the socio-demographic characteristics of their children with autism.Material and Method: A descriptive analytical study conducted during the period from January 15, 2023, to December 1, 2023, on a sample of voluntary participants consisting of 120 parents in Al-Diwaniyah Teaching Hospital. Data were collected through the use of a …

Serum Level Of Il-4 And Il-13 And Their Association With Disease Pathogenesis In Patients With Eczema, Shurooq Salim Murad, Heyam Qaid Mohammad

Al-Qadisiyah Medical Journal

Background: As the most common chronic skin illness with a genetic foundation, eczema is an inflammatory skin condition driven by cytokines. People with AD suffer from a significant burden that affects their physical, mental, social, and financial well-being.  The cytokines are important in eczema disease. Interleukins regulate immunity. Lack impairs immunity or causes autoimmune disorders. Objectives: This study is aiming to investigate whether inflammatory cytokine (IL-4, IL-13) levels in the blood correlate with eczema disorder. Methods: This case-control study is based on 60 patients who have been diagnosed with eczema disorder with a 60-person apparently healthy control group. 4 ml …

Comprehensive Study Of Pediatric Migraine Based On Patient Data Of Demographic, Characteristic, And Treatment Outcomes, Shaima’A Dakhel Abdulhassan, Safa’A Dakhel Abdulhassan

Al-Qadisiyah Medical Journal

Introduction: Migraine is a common neurological disorder in pediatric consultations. It is often disabling and influencing negatively the quality of life of pediatric migraine patients (PMPs). Aim: This study aimed to characterize the demographic profile of 98 PMPs from outpatient and private clinics in Al-Diwaniyah City, Iraq. This study describes demographic distribution, migraine characteristics, associated symptoms, familial history, trigger factors, and treatment outcomes of PMPs. Patients and Methods: The dataset had the following variables: age, sex, duration and severity of the migraines, frequency of attacks, associated symptoms, family history, trigger factor, types of treatments, and follow-up duration. Descriptive statistics were …

The Role Of Il-13 Serum Levels With Its Genetic Polymorphism In The Risk Of Developing Chronic Rhinosinusitis, Baneen Mohammed Ali Hussein, Ibrahim Abdulmajeed Mustafa

Al-Qadisiyah Medical Journal

Background: Chronic rhinosinusitis (CRS) represents a prolonged inflammatory condition of both nasal cavity and paranasal sinuses which extends more than 12 weeks without any sign of improvement. This condition affects work attendance along with productivity levels and quality of life detrimentally. Objective: To find out whether IL-13 rs1800925 C/T-1055 genetic polymorphism and its serum levels have a risk value for CRS disease. Methods: Three groups have been used as the basis for a case-control study. Thirty patients with a history of chronic rhinosinusitis with nasal polyp; thirty patients with a history of chronic rhinosinusitis without nasal polyp; and thirty healthy …

Intratympanic Steroids In Ménière's Disease: Impact On Vertigo, Hearing, And Quality Of Life, Osama Awaad Ali, Mohammed Saeed Abd Ali

Al-Qadisiyah Medical Journal

Background: Ménière’s disease (MD) is an audiovestibular debilitating condition characterized by episodic vertigo, variable degrees of hearing loss, tinnitus, and aural fullness. Objective: To evaluate the efficacy of intratympanic steroid therapy in combination with standard treatment compared to standard therapy alone on managing signs of MD. Patients and methods: Eighty patients diagnosed with MD were randomly allocated into one of the treatment groups. Patients of group A received standard therapy (betahistine, low-salt diet, and diuretics), while patients of group B received standard therapy in addition to intratympanic steroid injections (dexamethasone 4 mg/mL). Vertigo severity (Dizziness Handicap Inventory (DHI) score), hearing …

Occupational Resilience (Part 1): Origins And Significance To Health And Well-Being, Bernard A. Muriithi, Jyothi Gupta

Occupational Therapy Faculty Scholarship

Occupational resilience (OR) is a novel concept emerging in occupational therapy and occupational science, with significant implications for the field. However, its definition is still evolving and needs clarity and consensus. In this article, we offer a definition inspired by the real-life experiences of refugee immigrants who have been resettled in the United States of America (USA). We define OR as the ability to persist in an occupation, where the duration and intensity of engagement are the essential contributors. Therefore, we propose that three elements, occupation, intensity, and duration, constitute the nature of OR and shape how occupation impacts health, …

Occupational Resilience (Part 2): Toward A Cross-Culturally Relevant Measure Of A Novel Construct, Bernard A. Muriithi, Milan Bimali

Occupational Therapy Faculty Scholarship

Occupational resilience (OR) refers to an individual’s ability to persist in performing an occupation, with the duration and intensity of engagement determining resilience for each occupation. It is a key determinant of both the manner and the extent to which occupations influence health; therefore, it is a promising construct with several potential applications. There are currently no validated OR measures; which problematizes its application. Three considerations were made in designing the Occupational Resilience Measure (ORM 1.0) and evaluating its potential as a cross-culturally relevant measure of OR: 1) the findings of a published study of lived experiences of refugees from …

The Effect Of Neoadjuvant Chemoradiotherapy On Perioperative Outcomes In Rectal Cancer Patients Following Stoma Reversal-A Retrospective Cohort Analysis, Mary Junak, Rosemarie Turk, Mohammad Afaque Alam, Eli Thompson, David Schaub, Joseph Gunderson, Anesu S. Masango, Srikar Kollipara, Andrea Moreno, Daniom Tecle, Valentine N. Nfonsam

School of Medicine Faculty Publications

BACKGROUND: Anastomotic leak after reversal of an ostomy is a significant complication in rectal cancer patients. The effects of neoadjuvant chemoradiotherapy (NCRT) on outcomes following stoma reversal are not well established. The aim of our study was to evaluate the effect of NCRT on outcomes in rectal cancer patients following stoma reversal. METHODS: We performed a [2005-2012] retrospective cohort analysis of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP), including adult (≥18 years) rectal cancer patients who had elective stoma reversal. Patients were stratified into those who received NCRT and those who did not. Primary outcomes were anastomotic …

Co-Developing Strategies For Leprosy Management In Malaysia: A Transdisciplinary Research Approach Involving Individuals Affected By Leprosy And Other Stakeholders, Norana Abdul Rahman, Vaikunthan Rajaratnam, Ruth Mh Peters, Marjolein Bm Zweekhorst, Pamela Wright Phd, Ms, Med, Rn, Cen, Karen Morgan, Mohamed Rusli Abdullah

Publications

Despite Malaysia's low leprosy prevalence, new cases continue to emerge in rural and Indigenous communities. National strategies often prioritise elimination and surveillance, while overlooking the needs and challenges of individuals affected by leprosy and those managing their care. This study employed a transdisciplinary research approach, guided by the Dialogue Model, to co-develop context-specific strategies to improve the lives of those affected through participatory engagement with both groups. Conducted across three high-burden states in Peninsular Malaysia, the research involved a desk review and stakeholder mapping, followed by 40 in-depth interviews with affected individuals and other stakeholders. These were complemented by a …

A Study Of Perceptions, Readiness, Benefits, And Barriers Related To Exoskeleton Adoption In New Jersey’S Warehousing Sector, Terry Asante

Theses

The warehousing industry in New Jersey remains a vital component of the region's logistics network, employing more than 200,000 workers who routinely engage in lifting, bending, overhead reaching, and other physically demanding activities. These exposures contribute to musculoskeletal disorder (MSD) rates that exceed national averages, particularly affecting the low back and shoulders. Nationally, MSDs account for an estimated $420 billion in combined direct and indirect costs each year, underscoring the need for interventions that can effectively reduce biomechanical strain. Industrial exoskeletons have emerged as a potential solution, with prior research demonstrating reductions in muscle activation, perceived exertion, and fatigue during …

Analysis And Numerical Investigation Of A Breast Cancer Treatment Model Incorporating Ketogenic Diet And Immune Boosters Via Optimal Control Theory, Kunnisai Muniroh, Ummu Habibah, Wuryansari Muharini Kusumawinahyu, Nur’Izzati Hamdan

Mathematical Modelling and Numerical Simulation with Applications

This paper develops a mathematical model to investigate breast cancer dynamics by incorporating tumor–immune interactions, ketogenic diet effects, and medical treatment. The model is formulated as a system of nonlinear ordinary differential equations and analyzed within an optimal control framework. Time-dependent control variables are introduced to represent treatment strategies aimed at minimizing tumor progression while reducing therapeutic costs. The model’s well-posedness is established through positivity and boundedness analysis. The necessary conditions for optimality are derived using Pontryagin’s Minimum Principle, resulting in a coupled system of state and adjoint equations. Numerical solutions are obtained using the fourth-order Runge–Kutta method combined with …

Inflammatory Co-Regulation Of Voltage-Gated Sodium Channels And Na,K-Atpase In Metastatic Breast Cancer, Steven D. Scahill, Kelly Jean Sherman, Dennis Paul

School of Graduate Studies Faculty Publications

Sodium regulation is a potentially major driver of cancer metastasis. Voltage-gated sodium channels (VGSCs) and Na,K-ATPase are sodium transporters that are upregulated in many advanced carcinomas and are implicated as metastatic drivers. However, little is known about what drives this overexpression, how these proteins influence metastatic behavior, or whether these complementary sodium transporters are co-regulated in cancer. Using sodium transporter regulation in healthy neurons as a model, the present study demonstrated that the inflammatory mediator tumor necrosis factor alpha (TNFα) affects the expression of VGSCs and Na,K-ATPase in an in vitro model of metastatic breast cancer. Acute TNFα challenge increased …

Hepatitis B Surface Antigen And Liver Function Tests As Prediction Markers For Patients Infected With The Hepatitis B Virus., Maitham N. Madhi, Wissam Salih Abood

Al-Qadisiyah Medical Journal

Background: The infection with the hepatitis B virus represents a significant global health challenge with serious complexities like the failure of the liver and hepatocellular carcinoma. It results in an estimated mortality of 1.12 million cases in 2022. Aim of Study: This study aimed to use hepatitis B surface antigen and liver function tests as prediction markers for patients infected with the hepatitis B virus and compare them with viral load in Wasit Province, Iraq. Materials and Methods: This study involved 75 patients, both male and female, who made up the study population. Hepatitis B virus (HBV)-positive patients' samples were …

The Validity Of Il12 And Mirna-140-5p As Potential Biomarkers Of Asthma, Hawraa Khalid Abdul Hussien, Manal Mohammed Kadham

Al-Qadisiyah Medical Journal

Background: Asthma is a chronic respiratory disorder characterized by airway inflammation, hyperresponsiveness, and variable airflow limitation. It affects millions worldwide and results from complex interactions between genetic, environmental, and immunological factors. Aim: To evaluate serum IL-12 levels and miRNA-140-5p expression in asthma patients compared to healthy controls and to explore their potential as diagnostic and follow-up biomarkers. Methods: The study included 60 patients diagnosed with asthma and 40 apparently healthy controls. Venous blood samples (5 mL) were collected under aseptic conditions from each participant. Serum IL-12 concentrations were measured using ELISA, and miRNA-140-5p expression was quantified by RT-qPCR following standard …

Impact Of Renal Dysfunction On In-Hospital Outcomes In Patients With Acute Coronary Syndrome, Kareem M Khalaf Al-Sharea, Falah A Bdulhasan Deli, Haidar Ali Musa

Al-Qadisiyah Medical Journal

Background: The outcome is poor in patients with acute myocardial infarction (MI) who have renal dysfunction in long-term follow-up. Less is known about the outcome of acute MI in the short term. Objectives: We aimed to evaluate the outcome of patients with acute coronary syndrome (ACS) across varying degrees of renal dysfunction. Materials and methods: Seventy patients presenting with ACS, including ST-segment elevation MI (STEMI), non-ST-segment elevation MI (NSTEMI), and unstable angina (UA), were enrolled in this prospective observational study. Sociodemographic and clinical characteristics and in-hospital outcomes were compared for patients according to glomerular filtration rate (GFR). Results: Patients with …

Evaluation Of Impact Of Some Epidemiologic Factors On The Bronchiolitis Caused By Respiratory Syncytial Virus (Rsv) In Infants And Young Children Under 5 Years Old In Al- Diwaniyah Province, Rajaa Abd Hamaadi Chaloob, Wissam Salih Abood

Al-Qadisiyah Medical Journal

Background:. The biggest viral cause of bronchiolitis and one of the major agents behind respiratory-tract infections globally is the Human Respiratory Syncytial Virus (HRSV). RSV is transmitted through airborne droplets or close contact with contaminated objects. Objective: The purpose of this research is to detect major risk factors associated with susceptibility to and severity of bronchiolitis in infants and young children under the age of five caused by respiratory syncytial virus (RSV).  study design to detect antibodies Immunoglobulin M (IgM) for human RSV in serum samples by using specific enzyme-linked immunosorbent assay (ELISA) kits as a diagnostic test Methods: This …

Staff Education To Improve Patient Outcomes Through Bedside Shift Report In A Skilled Nursing Facility, Ngum Avwontom

Walden Dissertations and Doctoral Studies

Abstract Problem: Inconsistent shift handoff communication in skilled nursing facilities (SNFs) contributes to adverse patient outcomes, including medical errors, falls, and pressure ulcers. Bedside shift reports (BSRs) are an evidence-based, patient-centered strategy to mitigate these risks, yet implementation at the project site was inconsistent. Methods: This staff education project implemented a standardized BSR program in a 100-bed SNF over seven weeks. The intervention trained 18 nursing staff (RNs, LPNs, CNAs) on BSR using the Situation-Background-Assessment-Recommendation (SBAR) communication framework. A pre- and post-test design was used to evaluate the impact on staff knowledge, shift report duration, and patient safety outcomes, including …