Medicine and Health Sciences Commons^™

The Use Of Electronic Notifications To Improve Guideline Adherence In Amiodarone Adverse Reaction Monitoring, Naruepat Sangpornsuk, Teetouch Ananwattanasuk

Chulalongkorn Medical Journal

Background: Amiodarone is an antiarrhythmic drug that can cause side effects on the thyroid, liver, lungs, vision, and nervous system. Guidelines for monitoring and surveillance of these side effects have been established since 2000, but adherence to them is low in many countries including Thailand. An electronic alert system was implemented to remind physicians of the monitoring guideline at Vajira Hospital, Navamindradhiraj University, Thailand since 23 August 2023.

Objective: This study aimed to compare adherence with the amiodarone guideline before and after implementing an electronic notification system (primary outcome) and to assess the incidence of amiodarone-related adverse reactions (secondary outcome). …

The Association Between Sarcopenia And Functional Outcomes After Bipolar Hemiarthroplasty In Elderly Patients With Displaced Femoral Neck Fracture. Structural Equation Modeling., Sanzhar Artykbay, Stephen J. Kerr, Saran Tantavisut

Chulalongkorn Medical Journal

Background: Sarcopenia is an underrecognized condition that may impair recovery after hip fracture surgery in older adults.

Objectives: This study aimed to assess the impact of sarcopenia on functional outcomes and hip muscle strength in elderly individuals with femoral neck fractures while accounting for other potential confounding factors through a structural equation model (SEM).

Methods: Between January 2023 and October 2024, a prospective cohort study at a tertiary university hospital enrolled patients aged 60 and older undergoing bipolar hemiarthroplasty for displaced femoral neck fractures. Functional recovery was evaluated at 3-months follow-up using the Barthel Index (BI), Short Physical Performance Battery …

Clinical Outcomes Between Transradial And Transfemoral Primary Percutaneous Coronary Intervention In St-Segment Elevation Myocardial Infarction Patients In Chonburi Hospital: A Retrospective Study, Artit Torpongpun, Pornchai Ngamjanyaporn, Woravit Tantisiriwat, Chanadda Rutnuntamongkon, Gahn Nakornchai, Paramaporn Suttirut

Chulalongkorn Medical Journal

Background: According to recent global data, transradial primary PCI in ST-elevation myocardial infarction (STEMI) patients has demonstrated better procedural outcomes compared to transfemoral PCI.

Objective: To compare the clinical outcomes between transradial and transfemoral primary PCI in STEMI patients at Chonburi Hospital.

Methods: Patients diagnosed with STEMI who underwent PCI at Chonburi Hospital between October 1, 2016, and September 30, 2023, were enrolled. Clinical data were obtained through a retrospective review of medical records and the Chonburi Hospital STEMI registry database.

Results:A total of 913 patients were eligible for statistical analysis, with 532 and 381 patients undergoing PCI via …

Factors Influencing Outcomes In Neonatal Abdominal Surgery: Surgeons’ Perspectives, Nimmita Srisan, Kanyarat Olarachin, Pattamon Sutthatarn, Katawaetee Decharun, Prapapan Rajatapiti, Somboon Reukvibunsi, Paisarn Vejchapipat

Chulalongkorn Medical Journal

Neonatal abdominal surgery was often indicated by congenital conditions, presenting significant risks of morbidity and mortality. However, comprehensive surgical data and identification of complication-related risk factors still receive little attention.

Purpose: Our objectives were to characterize neonatal patients undergoing abdominal surgery and to identify prognostic factors influencing complications and mortality in those patients.

Methods: A retrospective study was conducted on newborn patients aged between 0-30 days undergoing index surgery at a university hospital from 2013 to 2021. Categorical data were compared between the without-complication group and the with-complication group using the Chi-square tests and Fisher-Exact tests. Continuous data were analyzed …

Discharge Rates From Pediatric Emergency Departments Against Medical Advice Can Be Reduced By Improving Service Quality, Sounira Mehri, Josef Finsterer

Saudi Medical Journal

No abstract provided.

Integrating The Private Sector Into Surgical Residency Training: Insights From Dr. Sulaiman Al Habib Medical Group, Saudi Arabia, Nuha A. Alsaleh

Saudi Medical Journal

No abstract provided.

Covid-19–Associated Rhabdomyolysis In Hospitalized Patients: Retrospective Cohort Study, Paula Esquerdo-Serrano, Silvia Otero-Rodriguez, Hector Pinargote-Celorio, Sergio Reus, Esperanza Merino, José-Manuel Ramos-Rincón

Saudi Medical Journal

Objectives: To determine the frequency of rhabdomyolysis in patients hospitalized with COVID-19 and to characterize their clinical features and outcomes. Methods: All adults admitted to the hospital were included in this single-center retrospective cohort study with COVID-19 at a tertiary care institution in Alicante, Spain, between March 2020 and March 2024. A creatine kinase (CK) threshold of 1000 U/L or higher was used to define rhabdomyolysis. Demographic, clinical, laboratory, treatment, and outcome data were collected. Patients with and without rhabdomyolysis were compared, and factors associated with in-hospital mortality (IHM) were analyzed. Results: Among 7,590 hospitalized COVID-19 patients, 20 developed rhabdomyolyses …

Coronary Artery Ectasia: A 10-Year Experience At A Single Center In Saudi Arabia, Talal F. Aljabbary, Meshal S. Alhamed, Mohamed H. Ismaeel, Abdulrahman O. Alhaqbani, Abdullah S. Alhumimidi, Nouf A. Alanazi, Ayman M. Alsaleh, Khalid M. Aljohani, Waleed M. Alharbi, Mostafa Q. Alshamiri

Saudi Medical Journal

Objective: To assess the incidence of coronary artery ectasia (CAE) and its associated clinical characteristics and outcomes over a long follow-up period in Saudi Arabia. Methods: We retrospectively analyzed all coronary angiography procedures performed between January 2013 and June 2023. Patients with CAE were included in the final analysis. Results: During the 10-year period, 10,397 patients underwent coronary angiography. The CAE was diagnosed in 242 patients, yielding an incidence of 2.3%. The majority were male (92.6%). The average age was 57.15 ± 11.76 years. The right coronary artery (RCA) was the most involved vessel (65.2% of all patients). The most …

Tumor Markers And Pancreatic Enzymes Reflect Early Pancreatic Dysfunction In Type 2 Diabetes, Walaa Mohammedsaeed, Suliman Alharbi, Lama Alraddadi, Saja Aljohani, Talat Almehmadi, Sarah Alawfi

Saudi Medical Journal

Objective: To evaluate whether pancreatic enzymes and tumor markers reflect early pancreatic dysfunction in patients with type 2 diabetes mellitus (T2DM). Methods: In this cross-sectional study conducted between January 2023 and January 2024, 300 Saudi adults with T2DM were assessed for serum CA19-9, CA125, amylase, and lipase. Associations with glycemic control, insulin resistance (homeostatic model assessment for insulin resistance [HOMA-IR]), and metabolic parameters were examined using multivariable linear and logistic regression adjusted for age, sex, body mass index, diabetes duration, lipid profile, and medication use. Receiver-operating characteristic analyses evaluated biomarker performance for identifying poor glycemic control (HbA1c >8.5%). Exploratory analyses …

Male Pelvic Health In Saudi Arabia: Knowledge–Practice Gap In Pelvic Floor Muscle Exercises And Implications For Preventive Physiotherapy And Health Policy, Wael A. S. Alghamdi

Saudi Medical Journal

No abstract provided.

Demographic Profiles, Clinical Characteristics, And Meteorological Context Of Heat-Related Illnesses Among Hajj Pilgrims In 2023, Ghadah Alsaleh, Majed Alsalamah, Fahad Alamri, Fatemah Alsaleh, Anas Khan

Saudi Medical Journal

Objective: To describe the demographic profiles, clinical characteristics, and meteorological context of heat-related illnesses among Hajj pilgrims in 2023.

Methods: A retrospective cross-sectional study was conducted using data from 1,129 pilgrims diagnosed with HRIs across healthcare facilities in Mecca, Mina, and Arafat. Demographic and clinical data were extracted from the Hajj Health Information System, while temperature, humidity, wind speed, and rainfall records were obtained from the National Center for Meteorology.

Results: Heat exhaustion (48.2%) and heatstroke (37.4%) were the most common diagnoses, with 24.9% of the cases requiring hospitalization. Males represented 55.4% of cases and accounted for 51.2% of …

Obesity's Role In Stroke Incidence Among Smokers: An Assessment Of Confounding, Interaction, And Mediation Effects, Saeed Awad M. Alqahtani, Moutasem Salih Aboonq

Saudi Medical Journal

Objectives: To examine the association between body mass index (BMI) category and history of stroke among current smokers, while assessing potential confounding, effect modification by age, and mediation by cardiovascular comorbidities. Methods: Data were analyzed from 53,939 current adult smokers participating in the 2021 Behavioral Risk Factor Surveillance System (BRFSS). Survey-weighted logistic regression estimated the association between BMI categories (underweight, normal, overweight, obese) and self-reported stroke history. The study assessed multicollinearity and adjusted for sociodemographic and health variables. Interaction terms were tested to evaluate effect modification by age, and exploratory decomposition analysis was used to assess mediation by conditions such …

Prevalence And Antimicrobial Susceptibility Patterns Of Nosocomial Bacteria Across Different Units At King Faisal Complex Hospital, Taif, Kingdom Of Saudi Arabia, Nahed Hawsawi, Renad N. Al-Jaiud, Layal L. Khyyat, Kholoud Alsulimany, Manhal Shabat

Saudi Medical Journal

Objectives: Nosocomial infections significantly impact patient morbidity, mortality, and healthcare costs. To determine the prevalence, bacteriological profiles, antimicrobial susceptibility patterns, and resistance distribution of pathogens causing nosocomial infections at King Faisal Medical Complex, Taif, Kingdom of Saudi Arabia. Methods: This cross-sectional study was conducted between September 2023 and March 2024 at different hospital units following ethical approval. Samples (n = 667) were collected from patients (both genders; all ages) exhibiting infection symptoms ≥ 48 h post-admission and pre-antibiotic administration. Bacterial identification involved culture, Gram staining, and biochemical tests. Antimicrobial susceptibility was tested using the Phoenix100 system. Results: Of 667 patients, …

From Early Adversity To Adult Health: Quality-Of-Life Consequences In A Mental Illness In Saudi Arabia, Rawan Saad Alghamdi, Ahmad A. Mirza, Ibrahim Fae Asiri, Fatemah Samir Alghamdi, Nawaf Abdulaziz Alharthi, Shaymaa A. Abdalal, Iman K. Ramadan

Saudi Medical Journal

Objectives: Childhood trauma (CT) is prevalent among bipolar disorder (BD) patients and exacerbates clinical outcomes, which may impact the quality of life (QoL). This study explores the prevalence of CT and its association with QoL among BD patients in Saudi Arabia. Methods: Cross-sectional study conducted among adults with BD during the euthymic phase. Sample size was estimated using a single-proportion approach (target n=141), and participants recruited by convenience sampling of eligible outpatients. CT was assessed using the Childhood Trauma Questionnaire (CTQ), and QoL using the the Brief Quality of Life in Bipolar Disorder (Brief QoL.BD). Results: The CT prevalence was …

Re-Emergence Of Pertussis In The Pediatric Population: A Tertiary Care Center's Experience, Haya S. Alshaibani, Tahir K. Hameed, Khaled H. Alsager, Mohammed A. Alshaalan, Syed F. Jamil

Saudi Medical Journal

Objectives: To describe the 2024 surge in pertussis cases in the pediatric population in a large tertiary care center in Riyadh, Saudi Arabia. Methods: A retrospective observational study was conducted on children aged 0–14 years with PCR-confirmed Bordetella pertussis infection diagnosed at a tertiary hospital in Riyadh between January and December 2024. Patients older than 14 years, with negative or indeterminate PCR results, or diagnosed outside the study period were excluded, and demographic, immunization, clinical, and outcome data were analyzed. Results: A total of 36 children were diagnosed with pertussis, with 35 (97.2%) requiring hospital admission. The median age was …

A Retrospective Cohort Study Of Uterine Cancer Epidemiological Analysis And Age-Based Disparities In Saudi Arabian Population Across 32 Years, Sallwa M. Alshehre, Mohammad A. Althubiti

Saudi Medical Journal

Objectives: To investigate the burden of uterine tumour in Saudi Arabia during the past 32 years (1990–2021), with an emphasize on the prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Knowing these patterns strengthen the national aims of cancer control under Kingdom of Saudi Arabia (KSA) Vision 2030. Methods: A retrospective study was performed using data retrieved from the Global Burden of Disease (GBD) database. The work included population from Saudi Arabia between 1990 and 2021 and tested standardization age-specific metrics, involving uterine tumour incidence, prevalence, mortality, and DALYs. Results: Uterine tumour cases raised from 507 in 1990 to 6,366 …

Seroprevalence Of Hepatitis B And Hepatitis C In Patients Hospitalized In Palliative Care Service, Meryem Betos Koçak, Burcu Güler

Saudi Medical Journal

Objectives: Patients receiving palliative care often have complex comorbidities and frequent healthcare exposure, which may place them at risk for blood-borne infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV). However, data on the seroprevalence and prognostic impact of these infections in palliative populations remain limited. This study aimed to determine the seroprevalence of HBV and HCV markers in patients hospitalized in a palliative care unit and to assess their association with mortality. Methods: This retrospective study conducted on 545 adult patients a tertiary palliative care unit between 2018 and 2024. Demographic characteristics, comorbidities, nutritional support, mobility, …

Artificial Intelligence In Dialysis Therapies: Applications In Hemodialysis And Peritoneal Dialysis For Managing Infectious Diseases And Complications, Waleed H. Mahallawi

Saudi Medical Journal

This narrative review synthesizes evidence from a systematic literature search (2019–2025) on artificial intelligence (AI) applications in hemodialysis and peritoneal dialysis for managing infections and complications. Dialysis patients face infection rates 100-fold higher than the general population and sepsis mortality exceeding 35%. The AI, utilizing machine learning algorithms such as XGBoost, deep neural networks, and explainable AI tools, revolutionizes care through precise diagnostics, prognostics, and therapeutics. Key models demonstrate high accuracy in predicting bloodstream infections (area under the curve [AUC] 0.914), classifying peritonitis (F1 0.93), detecting SARS-CoV-2 (AUROC 0.82), and forecasting mortality (AUC 0.979). Therapeutically, AI guides antibiotic stewardship, reducing …

Post-Stroke Fatigue In Saudi Arabia: A Call To Action, Saad Z. Alqahtani

Saudi Medical Journal

Post-stroke fatigue (PSF) is a major consequence of stroke, with a prevalence of approximately 42–53% among stroke survivors. However, over the last 2 decades, only a few studies have explored PSF in Kingdom of Saudi Arabia (KSA). Findings from these studies show that PSF negatively impacts the quality of life of individuals with stroke. Furthermore, they emphasize the need for education for both health care providers and patients regarding PSF. This call-to-action mini narrative review identifies knowledge gaps and provides recommendations for both researchers and policymakers, including the need for standardized management and the exploration of hospital environment settings. Specifically, …

Contribution Of Interleukin-6 (Il-6) To Body Defense And Healing In Pulmonary Tuberculosis, Hasrah Junaidi, Annis C. Adi, Soedarsono Soedarsono, Soetjipto Soetjipto, Chatarina U. Wahyuni, Fariani Syahrul, Mahmudah Mahmudah, Zakiyuddin Zakiyuddin, Iskandar Arfan, Abdullah A. Mamun, Rubia Sari

Saudi Medical Journal

Objective: To examine the contribution of IL-6 to host defense and healing in pulmonary tuberculosis (TB). Pulmonary tuberculosis continues to pose a significant global health challenge, with disease outcomes determined by complex host–pathogen interactions. Interleukin-6 (IL-6), a multifunctional cytokine, has been implicated in immune regulation and tissue recovery during TB, but its specific role is not fully established. This review aimed to examine the contribution of IL-6 to host defense and healing in pulmonary TB. Methods: A comprehensive literature search was performed across PubMed, Scopus, Web of Science, ScienceDirect, and Medline following PRISMA guidelines, covering publications from 2015 to 2025. …

Impact Of Treatment On The Health-Related Quality Of Life Of Children With Cancer In Saudi Arabia, Fayzah Hussain Alhussain, Amany Anwar Saeed Alabdullah

Saudi Medical Journal

Objective: The impact of cancer on health-related quality of life (HRQOL) is considerable, particularly for children undergoing oncological treatment. While research has addressed HRQOL in childhood cancer survivors, less attention has been given to those actively undergoing treatment, including in Saudi Arabia. This systematic review aimed to address this gap by quantitatively evaluating studies reporting on the HRQOL of children in Saudi Arabia during their active cancer treatment phase. We also compare these findings with studies from around the world, emphasising demographic, medical and parental predictors of HRQOL. Methods: A comprehensive search of relevant databases (MEDLINE, CENTRAL, Embase, PsycINFO and …

Effects Of A Basketball Match On Heart Rate Variability In Collegiate Intramural Players, Unobatsha Mbaiwa

Master's Theses

Heart rate variability (HRV) is a standard non-invasive physiological marker used to asses the autonomic nervous system (ANS) function and cardiovascular adaptability. HRV reflects the natural variations in time between successive heartbeats (R-R intervals), which come as a result of the interaction between sympathetic and parasympathetic branches of the ANS (Shaffer & Ginsberg, 2017). Higher HRV compared to an individual's baseline is normally considered an indicator of greater parasympathetic (rest/digest) influence and more effective physiological recovery, whereas lower HRV relative to baseline is associated with sympathetic (fight/flight) dominance, fatigue, and increased physiological strain. Since the standardized HRV measurement criteria were …

Overweight And Obesity Among Southeastern Nigerian Lecturers And Its Association With Absenteeism And Presenteeism, Ezenwa Victor Ejikem

Walden Dissertations and Doctoral Studies

No abstract provided.

Barriers And Bridges: Exploring Factors That Shape Mental Health Service Utilization In Rural America, Margaret Wiwuga

Educational Specialist, 2020-current

Despite disproportionately higher suicide mortality rates and comparable prevalence of mental illness across urban and rural communities in the United States, rural populations across the nation experience significantly lower access to and utilization of mental health services, naturally leading to worse comprehensive outcomes. This literature review examines multifaceted factors shaping mental health service use in rural America, taking note of both barrier and enabling factors that impede or enable these unique populations’ willingness and ability to access and use mental health services. Ten articles published prior to September 9, 2025, were selected from the James Madison University Libraries’ Psychology and …

Black Maternal Mental Health: Counseling Considerations For Prenatal Depression And Anxiety, Morgan Renee Williams

Educational Specialist, 2020-current

The maternal mortality rate of Black women in the United States is four times higher than white women (Centers for Disease Control and Prevention, 2020). The CDC defines a maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy… but not from accidental or incidental causes” (Centers for Disease Control and Prevention, 2024, para. 1). This statistic is a consequence of the inequality within and outside of the American healthcare system (National Academies of Sciences, Engineering, and Medicine, 2020). For the purposes of this research, Black women are defined as any women …

What’S Behind The Mask: The Diagnostic Divide In The Female Autism Phenotype, Shelley Gies Alston

Educational Specialist, 2020-current

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by differences in social communication and restrictive, repetitive behaviors; however, women are diagnosed at significantly lower rates than men. This study examined whether DSM-5-TR diagnostic practices may contribute to the underdiagnosis and delayed identification of ASD in individuals assigned female at birth (AFAB), with attention to masking behaviors, gendered social expectations, and clinician interpretation of symptoms. Grounded in the Female Autism Phenotype (FAP), a retrospective mixed-methods study surveyed 12 AFAB individuals aged 18–24 who self-identified or were formally diagnosed with ASD. Participants completed a 44-item online survey including Likert-scale and open-ended …

Thrombin-Induced Myofibroblast Differentiation Is Regulated By Myocardin And Novel Effector Genes In Ipf Fibroblasts, Christiana Okeke

Biotechnology Theses

Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease characterized by fibroblast activation, excessive extracellular matrix (ECM) deposition, and irreversible respiratory decline. In this study, we investigated the role of myocardin and its downstream effectors, RGS5, DLGAP5, and TAGLN, in thrombin-induced myofibroblast differentiation and ECM remodeling using primary human IPF fibroblasts. Myocardin knockdown significantly attenuated thrombin-induced expression of profibrotic genes, including FN1, COL1A1, PAI-1, ACTA2, and CNN1, as well as the novel effectors RGS5, DLGAP5, and TAGLN, confirming myocardin as a central regulator of fibrotic signaling. Silencing RGS5 produced minimal effects on gene and protein expression despite minor downward …

Identification Of Proteins With Immune Stimulatory Activities From The Culture Filtrates Of Nontuberculous Mycobacteria, Christian Albert Agyei Acheampong

Biotechnology Theses

Nontuberculous mycobacteria (NTM) are the mycobacterial species other than Mycobacterium tuberculosis, which causes tuberculosis, and Mycobacterium leprae, which causes leprosy. Diseases caused by NTM are on the rise in the United States and are steadily becoming a significant public health problem globally, particularly in developed countries. Despite the ability of NTM pathogens to interact with the host immune system, the proteins responsible for eliciting host immune responses remain unidentified, making the accurate and timely diagnosis of the disease a challenge. In this study, we tested the hypothesis that NTM strains secrete proteins that stimulate immune responses. Our study …

From Evidence To Practice: Improving Diabetic Patient Outcomes By Increasing Statin Utilization, Elizabeth Mcfalls

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) prevention in patients with diabetes is essential, as heart disease remains the leading cause of death within this population (American Diabetes Association, n.d.). The purpose of this evidence-based project is to improve patient outcomes by enhancing adherence to statin therapy. A thorough literature review yielded 246 pieces of moderate-to-high-quality evidence; of these, eight articles were appraised in detail and selected for project inclusion. The strongest evidence identified four meaningful interventions. Thus, a multimodal approach was indicated for this project. This included addressing barriers to therapy, creating practice nudges, implementing a shared decision-making (SDM) tool, and utilizing clinical …

Reducing Catheter-Associated Urinary Tract Infections Through Staff Education In A Nursing Home Setting, Aderonke Abimbola Abatan

Walden Dissertations and Doctoral Studies

No abstract provided.