Medicine and Health Sciences Commons^™

Differential Levels Of Nutrients And Heavy Metals In Tilapia Collected From Drains In Egypt, Emily Burch

Theses and Dissertations

Tilapia is one of the most widely cultivated and consumed fish globally. In terms of human health, tilapia is an excellent source of protein, polyunsaturated fatty acids, and micronutrients. Tilapia and other aquatic species have become increasingly susceptible to contamination, as anthropogenic activities have been increasing around the world. Anthropogenetic activities often introduce high levels of contaminants, including heavy metals, into the marine environment. These contaminants often do not biodegrade, and they are absorbed by aquatic species. Contaminants can bioaccumulate and proceed in biomagnification up the fish food chain putting consumers at an increased risk of exposure. Heavy metals can …

Understanding The Acceptability And Effect Of Psychiatric Care Via Telemedicine As An Alternative Option For Patients Living With Intellectual Disabilities In Group Homes, Brittany M. Johnson, Annabelle J. Rowland, Jacob D. Coeur, Maxwell C. Klapow, Jean F. Pointon

Cooper Rowan Medical Journal

Telemedicine has become a popular alternative to in-person clinic visits in the field of psychiatry, but few studies examine the impact of telemedicine mental healthcare provided to patients with intellectual disabilities living in group homes. Our study aims to fill this gap in the literature. A ten-question survey was designed to evaluate the effect of telemedicine services on access to care, quality of care, and patient and caregiver stress. This survey was distributed to caregivers of patients living in group homes who received care at the University of Alabama Medical Center. The majority of respondents indicated that telemedicine visits improved …

Reasoning The Voice: Toward A Diagnostic And Prescriptive Technique In The Teaching Of Singing, Carlos E. Santelli

LSU Doctoral Dissertations

Voice pedagogy literature often draws a parallel between a doctor’s ability to diagnose illness and prescribe treatment, and a voice teacher’s ability to identify vocal obstacles and design solutions. The core of these parallel procedures lies in an ability to utilize critical reasoning skills within highly specific contexts. Medical literature describes this as “clinical reasoning” and has studied it as a learned process. Voice pedagogy literature has traditionally described this as an innate process which is solely developed through experience. This document broadly examines the ways in which medical literature has broken down clinical reasoning into specific cognitive processes and …

KCa2 And KCa3.1 Channels In The Airways: A New Therapeutic Target, Razan Orfali, Ali Alfaiz, Mohammad Asikur Rahman, Liz Lau, Young-Woo Nam, Miao Zhang

Pharmacy Faculty Articles and Research

K⁺ channels are involved in many critical functions in lung physiology. Recently, the family of Ca²⁺-activated K⁺ channels (K_Ca) has received more attention, and a massive amount of effort has been devoted to developing selective medications targeting these channels. Within the family of K_Ca channels, three small-conductance Ca²⁺-activated K⁺ (K_Ca2) channel subtypes, together with the intermediate-conductance K_Ca3.1 channel, are voltage-independent K⁺ channels, and they mediate Ca²⁺-induced membrane hyperpolarization. Many K_Ca2 channel members are involved in crucial roles in physiological and pathological …

Sirna Drug Delivery Across The Blood–Brain Barrier In Alzheimer's Disease, Muhammad Imran Sajid, Fahad Sultan Sheikh, Faiza Anis, Nourina Nasim, Rachita K. Sumbria, Surya M. Nauli, Rakesh K. Tiwari

Pharmacy Faculty Articles and Research

Alzheimer’s disease (AD) is a progressive neurodegenerative disease with a few FDA-approved drugs that provide modest symptomatic benefits and only two FDA-approved disease-modifying treatments for AD. The advancements in understanding the causative genes and non-coding sequences at the molecular level of the pathophysiology of AD have resulted in several exciting research papers that employed small interfering RNA (siRNA)-based therapy. Although siRNA is being sought by academia and biopharma industries, several challenges still need to be addressed. We comprehensively report the latest advances in AD pathophysiology, druggable targets, ongoing clinical trials, and the siRNA-based approaches across the blood–brain barrier for addressing …

How Did The Landscape Of Student Belonging Shift During Covid-19?, Shruti Misra, Neha Kardam, Jennifer Vanantwerp, Denise Wilson

University Faculty Publications and Creative Works

The goal of this study is to understand if and how emergency remote teaching (ERT) used during the COVID-19 pandemic changed the ways in which instructional support and interactions were linked to belonging among engineering students. Belonging is a fundamental human motivation associated with a wide range of positive psychological, educational, social, and job outcomes. Frequent and predominantly conflict-free interactions within a stable, relational framework of caring are required to facilitate belonging. To better understand potential shifts in belonging that occurred from prepandemic to mid-pandemic, this study used survey data from a cross-sectional dataset at a single, large institution comprised …

Barriers And Facilitators To Achieving Well-Being In Pediatric Providers, Whitney Marvin, Jillian Harvey, Natasha Ruth

Journal of Wellness

Introduction: Physician well-being has become increasingly important for health systems across the country due to the strong ties between quality, safety, and overall patient outcomes. Burnout has increased steadily and has been exacerbated by the COVID-19 pandemic. This study seeks to successfully identify factors that both enhance and detract from well-being in a cohort of pediatric faculty and advanced practice providers (APPs).

Methods: This study utilized a multimethod approach including surveys and a total of 8 semi-structured, virtual focus groups of pediatricians and advanced practice providers (orchestrated through Microsoft Teams) to understand perspectives on burnout and well-being. Each …

From Crisis Management To Multi-Level Interinstitutional Partnerships: Development Of The Southeastern Conference Deans Nursing Coalition, Jeannette O. Andrews, Victoria Niederhauser, Julie Sanford, Suzanne Prevost, Demetrius Porche, Janie Heath, Pamela Jeffries, Nancy Fahrenwald

School of Nursing Faculty Publications

The Southeastern Conference (SEC) Nursing Dean's Coalition is a purposeful alliance organized to collaboratively address several challenges that arose during the COVID-19 pandemic. Over the last three years, this strategic team of academic leaders has evolved from a crisis response team to a multidimensional support team, leveraging both individual and collective strengths, to provide several benefits to the dean members, as well as other SEC nursing faculty members, students, and institutions. Participation has grown from the original 12 deans to engage a broader team of associate deans and nurse leaders in faculty development, research, service, and diversity, equity, and inclusion. …

Aortic Stenosis Phenotypes And Precision Transcatheter Aortic Valve Implantation, Muzamil Khawaja, Hafeez Ul Hassan Virk, Dhrubajyoti Bandyopadhyay, Mario Rodriguez, Johao Escobar, Mahboob Alam, Hani Jneid, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Patients with a clinical indication for aortic valve replacement can either undergo surgical aortic valve replacement (SAVR) or Transcatheter Aortic Valve Implantation (TAVI). There are many different factors that go into determining which type of replacement to undergo, including age, life expectancy, comorbidities, frailty, and patient preference. While both options offer significant benefits to patients in terms of clinical outcomes and quality of life, there is growing interest in expanding the indications for TAVI due to its minimally invasive approach. However, it is worth noting that there are several discrepancies in TAVI outcomes in regards to various endpoints, including death, …

An Integrated Isothermal Nucleic Acid Amplification Test To Detect Hpv16 And Hpv18 Dna In Resource-Limited Settings, Kathryn A Kundrod, Maria Barra, Alexis Wilkinson, Chelsey A Smith, Mary E Natoli, Megan M Chang, Jackson B Coole, Akshaya Santhanaraj, Cesaltina Lorenzoni, Celda Mavume, Hira Atif, Jane Richards Montealegre, Michael E Scheurer, Philip E Castle, Kathleen M Schmeler, Rebecca R Richards-Kortum

Center for Medical Ethics and Health Policy Staff Publications

High-risk human papillomavirus (HPV) DNA testing is widely acknowledged as the most sensitive cervical cancer screening method but has limited availability in resource-limited settings, where the burden of cervical cancer is highest. Recently, HPV DNA tests have been developed for use in resource-limited settings, but they remain too costly for widespread use and require instruments that are often limited to centralized laboratories. To help meet the global need for low-cost cervical cancer screening, we developed a prototype, sample-to-answer, point-of-care test for HPV16 and HPV18 DNA. Our test relies on isothermal DNA amplification and lateral flow detection, two technologies that reduce …

Effects Of Age On Amplitude-Modulated Cvemp Temporal Modulation Transfer Function, Raghav H. Jha

Dissertations, 2020-current

With the aging population on the rise, the need for effective assessment tools to identify risk factors for falls among the elderly is paramount. One independent risk factor for falls is vestibular impairment, but the available vestibular diagnostic tests have limitations. A promising new methodology: amplitude-modulated tones to elicit a vestibular-evoked myogenic potential (AMcVEMP), offers a more detailed examination of vestibular (sacculo-collic reflex) functions. This method assesses non-linearities, synchrony, and magnitude, providing a more thorough evaluation compared to the conventional transient cVEMP. So far, AMcVEMP has only been utilized in young adults.

The current study aimed to investigate the impact …

Parents’ Perspectives On The Utility Of Genomic Sequencing In The Neonatal Intensive Care Unit, Amy A. Lemke, Michelle L. Thompson, Emily C. Gimpel, Katelyn C. Mcnamara, Carla A. Rich, Candice R. Finnila, Meagan E. Cochran, James M.J. Lawlor, Kelly M. East, Kevin M. Bowling, Donald R. Latner, Susan M. Hiatt, Michelle D. Amaral, Whitley V. Kelley, Veronica Greve, David E. Gray, Stephanie A. Felker, Hannah Meddaugh, Ashley Cannon, Amanda Luedecke, Kelly E. Jackson, Laura G. Hendon, Hillary M. Janani, Marla Johnston, Lee Ann Merin, Sarah L. Deans, Carly Tuura, Trent Hughes

School of Medicine Faculty Publications

Background: It is critical to understand the wide-ranging clinical and non-clinical effects of genome sequencing (GS) for parents in the NICU context. We assessed parents’ experiences with GS as a first-line diagnostic tool for infants with suspected genetic conditions in the NICU. Methods: Parents of newborns (N = 62) suspected of having a genetic condition were recruited across five hospitals in the southeast United States as part of the SouthSeq study. Semi-structured interviews (N = 78) were conducted after parents received their child’s sequencing result (positive, negative, or variants of unknown significance). Thematic analysis was performed on all interviews. Results: …

A Study Of Relationship Between Exertional Heat Illness And Heat Stress Levels, Rolando J. Fargas-Martinez

USF Tampa Graduate Theses and Dissertations

Introduction: Heat stress is clearly associated exertional heat illnesses (EHI) in workers in a number of studies. With expected increase in extreme thermal changes, an increase understanding the effects of heat stress conditions is necessary. The purpose of this study was to compare heat stress levels in a manufacturing plant to determine whether a relationship exists between heat stress level relative to the occupational exposure limit and exertional heat illness incidents.Methods: OSHA recordable heat illness cases (n=35) were collected over a three year period. Over the same period, hourly ambient Heat Index data was collected. For this manufacturing plant, heat …

Evaluation Of Two Methods To Estimate Wet Bulb Globe Temperature From Heat Index, Stephi Pofanl

USF Tampa Graduate Theses and Dissertations

The Wet bulb globe temperature (WBGT) is a common method to evaluate environmental factors that contribute to occupational heat stress. The Heat Index (HI) is readily available as an alternative to exposure methods. They both assess the most important contributors that are air temperature and humidity. WBGT also includes radiant heat and air motion. To account for radiant heat and/or air motion, some investigators have suggested adjustments to HI. The purpose of this study is to explore two methods to estimate the usefulness of WBGT from HI.

WBGT data were collected in a variety of locations that included direct sun …

Slc7a11 Expression Level Dictates Differential Responses To Oxidative Stress In Cancer Cells, Yuelong Yan, Hongqi Teng, Qinglei Hang, Lavanya Kondiparthi, Guang Lei, Amber Horbath, Xiaoguang Liu, Chao Mao, Shiqi Wu, Li Zhuang, M James You, Masha V Poyurovsky, Li Ma, Kellen Olszewski, Boyi Gan

Faculty, Staff and Student Publications

The cystine transporter solute carrier family 7 member 11 (SLC7A11; also called xCT) protects cancer cells from oxidative stress and is overexpressed in many cancers. Here we report a surprising finding that, whereas moderate overexpression of SLC7A11 is beneficial for cancer cells treated with H2O2, a common oxidative stress inducer, its high overexpression dramatically increases H2O2-induced cell death. Mechanistically, high cystine uptake in cancer cells with high overexpression of SLC7A11 in combination with H2O2 treatment results in toxic buildup of intracellular cystine and other disulfide molecules, NADPH depletion, redox system collapse, and rapid cell death (likely disulfidptosis). We further show …

An Improved Reporter Identifies Ruxolitinib As A Potent And Cardioprotective Camkii Inhibitor, Oscar E Reyes Gaido, Nikoleta Pavlaki, Jonathan M Granger, Olurotimi O Mesubi, Bian Liu, Brian L Lin, Alan Long, David Walker, Joshua Mayourian, Kate L Schole, Chantelle E Terrillion, Lubika J Nkashama, Mohit M Hulsurkar, Lauren E Dorn, Kimberly M Ferrero, Richard L Huganir, Frank U Müller, Xander H T Wehrens, Jun O Liu, Elizabeth D Luczak, Vassilios J Bezzerides, Mark E Anderson

Faculty, Staff and Students Publications

Ca2+/calmodulin-dependent protein kinase II (CaMKII) hyperactivity causes cardiac arrhythmias, a major source of morbidity and mortality worldwide. Despite proven benefits of CaMKII inhibition in numerous preclinical models of heart disease, translation of CaMKII antagonists into humans has been stymied by low potency, toxicity, and an enduring concern for adverse effects on cognition due to an established role of CaMKII in learning and memory. To address these challenges, we asked whether any clinically approved drugs, developed for other purposes, were potent CaMKII inhibitors. For this, we engineered an improved fluorescent reporter, CaMKAR (CaMKII activity reporter), which features superior sensitivity, kinetics, and …

Predictive Roles Of Baseline Stromal Tumor-Infiltrating Lymphocytes And Ki-67 In Pathologic Complete Response In An Early-Stage Triple-Negative Breast Cancer Prospective Trial, Nour Abuhadra, Ryan Sun, Clinton Yam, Gaiane M Rauch, Qingqing Ding, Bora Lim, Alastair M Thompson, Elizabeth A Mittendorf, Beatriz E Adrada, Senthil Damodaran, Kiran Virani, Jason White, Elizabeth Ravenberg, Jia Sun, Jaihee Choi, Rosalind Candelaria, Banu Arun, Naoto T Ueno, Lumarie Santiago, Sadia Saleem, Sausan Abouharb, Rashmi K Murthy, Nuhad Ibrahim, Aysegul Sahin, Vicente Valero, William Fraser Symmans, Jennifer K Litton, Debu Tripathy, Stacy Moulder, Lei Huo

Faculty, Staff and Student Publications

High stromal tumor-infiltrating lymphocytes (sTILs) are associated with improved pathologic complete response (pCR) in triple-negative breast cancer (TNBC). We hypothesize that integrating high sTILs and additional clinicopathologic features associated with pCR could enhance our ability to predict the group of patients on whom treatment de-escalation strategies could be tested. In this prospective early-stage TNBC neoadjuvant chemotherapy study, pretreatment biopsies from 408 patients were evaluated for their clinical and demographic features, as well as biomarkers including sTILs, Ki-67, PD-L1 and androgen receptor. Multivariate logistic regression models were developed to generate a computed response score to predict pCR. The pCR rate for …

Blm Overexpression As A Predictive Biomarker For Chk1 Inhibitor Response In Parp Inhibitor-Resistant Brca-Mutant Ovarian Cancer, Nitasha Gupta, Tzu-Ting Huang, Jayakumar R Nair, Daniel An, Grant Zurcher, Erika J Lampert, Ann Mccoy, Ashley Cimino-Mathews, Elizabeth M Swisher, Marc R Radke, Christina M Lockwood, Jonathan B Reichel, Chih-Yuan Chiang, Kelli M Wilson, Ken Chih-Chien Cheng, Darryl Nousome, Jung-Min Lee

Faculty, Staff and Student Publications

Poly(ADP-ribose) polymerase inhibitors (PARPis) have changed the treatment paradigm in breast cancer gene (BRCA)–mutant high-grade serous ovarian carcinoma (HGSC). However, most patients eventually develop resistance to PARPis, highlighting an unmet need for improved therapeutic strategies. Using high-throughput drug screens, we identified ataxia telangiectasia and rad3-related protein/checkpoint kinase 1 (CHK1) pathway inhibitors as cytotoxic and further validated the activity of the CHK1 inhibitor (CHK1i) prexasertib in PARPi-sensitive and -resistant BRCA-mutant HGSC cells and xenograft mouse models. CHK1i monotherapy induced DNA damage, apoptosis, and tumor size reduction. We then conducted a phase 2 study (NCT02203513) of prexasertib …

Mental Health Literacy In Polynesian Native Hawaiians And Other Pacific Islanders: A Pilot Cross-Sectional Study, Kealoha Sarah Reiko Snow

Theses and Dissertations

Background: High prevalence of mental health problems and underutilization of mental health treatment are more severe among the Native Hawaiian and Other Pacific Islander (NHPI) population and remain misunderstood and understudied. Examining mental health literacy (MHL)–the knowledge and beliefs about mental disorders which aid their recognition, management, or prevention–has been shown to identify barriers to seeking and receiving care. Objectives: This study aimed to assess the level of MHL in Polynesian NHPIs and identify associated demographic variables. Methods: Data for this pilot cross-sectional study were collected from 298 US Polynesians via an online questionnaire of the Mental Health Literacy Scale …

Combating Counterfeit Medicines: A Case Study Of The Egyptian Pharmaceutical Traceability System, Nourhan Yasser Ahmed Abdelfatah

Theses and Dissertations

Counterfeit medicines are a global challenge that has attracted the attention of many authorities in recent years. The problem worsened dramatically, causing adverse public health impacts and significant financial repercussions. Many countries, including Egypt, have attempted to adopt pharmaceutical track-and-trace systems to secure supply chains. Despite the significance of the problem, only a few scholars have studied the topic in Egypt. This qualitative study seeks to bridge the research gap and provide a clearer picture of counterfeit medicines in the Egyptian context. In addition, it aims to understand the role of the Egyptian Drug Authority and the policy motivations behind …

Interplay Between Vsd, Pore, And Membrane Lipids In Electromechanical Coupling In Hcn Channels, Ahmad Elbahnsi, John Cowgill, Verena Burtscher, Linda Wedemann, Luise Zeckey, Baron Chanda, Lucie Delemotte

2020-Current year OA Pubs

Hyperpolarized-activated and cyclic nucleotide-gated (HCN) channels are the only members of the voltage-gated ion channel superfamily in mammals that open upon hyperpolarization, conferring them pacemaker properties that are instrumental for rhythmic firing of cardiac and neuronal cells. Activation of their voltage-sensor domains (VSD) upon hyperpolarization occurs through a downward movement of the S4 helix bearing the gating charges, which triggers a break in the alpha-helical hydrogen bonding pattern at the level of a conserved Serine residue. Previous structural and molecular simulation studies had however failed to capture pore opening that should be triggered by VSD activation, presumably because of a …

Parents' Perspectives On The Utility Of Genomic Sequencing In The Neonatal Intensive Care Unit, Amy A Lemke, Kevin M Bowling, Et Al.

2020-Current year OA Pubs

BACKGROUND: It is critical to understand the wide-ranging clinical and non-clinical effects of genome sequencing (GS) for parents in the NICU context. We assessed parents' experiences with GS as a first-line diagnostic tool for infants with suspected genetic conditions in the NICU.

METHODS: Parents of newborns (N = 62) suspected of having a genetic condition were recruited across five hospitals in the southeast United States as part of the SouthSeq study. Semi-structured interviews (N = 78) were conducted after parents received their child's sequencing result (positive, negative, or variants of unknown significance). Thematic analysis was performed on all interviews.

RESULTS: …

Interprofessional Teamwork Through Remote Collaboration: A Mixed-Methods Approach, Sabina Kupershmidt, Tracy Cleveland, Mandy J. Williams, Whitney Lucas Molitor

Aesculapius Journal (Health Sciences & Medicine)

Introduction: Quality health care relies on effective, patient-centered teamwork. Interprofessional education and learning is one of the foundations of health education. These principles were challenged during the COVID-19 pandemic. We sought to determine whether a collaborative, online learning activity would be experienced as interprofessional by learners from eight health professions.

Methods: A mixed-methods, cross-sectional cohort study with retrospective analysis of survey data was utilized. Two custom-designed exit surveys to assess team behaviors: one from the learners’, the second from the faculty observers’ perspective. A thematic analysis of two open-ended questions was completed.

Results: Nursing was the largest discipline (45 %) …

Impact Of Food Environments On Obesity Rates: A State-Level Analysis., Elizabeth Cerceo, Elena Sharma, Anne Boguslavsky, Jean-Sebastian Rachoin

Cooper Medical School of Rowan University Departmental Research

INTRODUCTION: Limited access to healthy food in areas that are predominantly food deserts or food swamps may be associated with obesity. Other unhealthy behaviors may also be associated with obesity and poor food environments.

METHODS: We calculated Modified Retail Food Environment Index (mRFEI) to assess food retailers. Using data collected from the Behavioral Risk Factor Surveillance System (BRFSS) survey, the NJ Department of Health (NJDOH), and the US Census Bureau, we conducted a cross-sectional analysis of the interaction of obesity with the food environment and assessed smoking, leisure-time physical activity (LPA), and poor sleep.

RESULTS: There were 17.9% food deserts …

2023 June 20 - Medical Student Education Committee Retreat Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

2023 June 20 - Medical Student Education Committee Annual Meeting Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Chronic Venous Insufficiency With Emphasis On The Geriatric Population., Harvey N. Mayrovitz, Kawaiola C. Aoki, Jessica Colon

HPD Articles

The underpinning of Chronic Venous Insufficiency (CVI) is valvular dysfunction, which manifests on a spectrum depending on the severity of insufficiency and duration of the disease. The mainstay of treatment relies on compression therapy of a proper type and intensity. In older adults, special consideration must be taken during the patient encounter to account for age-related factors. This review discusses the clinical presentation, diagnosis, and mimicking of CVI, focusing mainly on older adults. The epidemiology, risk factors, disease burden, and grave complications -- such as thrombosis and ulceration, are reviewed. The physiological impacts of CVI are described, providing the background …

The Association Between Pelvic Floor Dysfunction And Mental Health In Natal Females With A Focus On Native American Populations, Lexxie Gramke

Dissertations

Purpose

Over half of natal females in the United States suffer from pelvic floor dysfunction (PFD). PFD can increase risk of mental health sequelae; however, no studies have been conducted examining the association between mental health and PFD in the Native American (NA) population. This dissertation aims to evaluate the association between PFD, with a focus on overactive bladder (OAB), and mental health in females with specific attention to NAs.

Methodology

A current state of the science review examined the literature for associations between OAB with depression and anxiety in females. Utilizing this literature review, a theoretical model was constructed …

Striatal Dopamine Synthesis And Cognitive Flexibility Differ Between Hormonal Contraceptive Users And Nonusers, Caitlin M Taylor, Daniella J Furman, Anne S Berry, Robert L White, William J Jagust, Mark D'Esposito, Emily G Jacobs

2020-Current year OA Pubs

In rodents and nonhuman primates, sex hormones are powerful modulators of dopamine (DA) neurotransmission. Yet less is known about hormonal regulation of the DA system in the human brain. Using positron emission tomography (PET), we address this gap by comparing hormonal contraceptive users and nonusers across multiple aspects of DA function: DA synthesis capacity via the PET radioligand 6-[18F]fluoro-m-tyrosine ([18F]FMT), baseline D2/3 receptor binding potential using [11C]raclopride, and DA release using methylphenidate-paired [11C]raclopride. Participants consisted of 36 healthy women (n = 15 hormonal contraceptive users; n = 21 naturally cycling/non users of hormonal contraception), and men (n = 20) as …

Factors Associated With Postpartum Care During The Fourth Stage Of Labor In Nepal: A Hospital-Based Cross-Sectional Study, Ashok Kumar Paudel, Muni Raj Chhetri, Ambika Baniya, Mamta Chhetri, Aafrin Gurung

Journal of Social, Behavioral, and Health Sciences

Postnatal care is an important part of maternal and neonatal care, and life-threatening complications can occur during the postpartum period. Empirical information on the level of postpartum care services is generally scarce in Nepal. Key elements of postpartum care during the fourth stage of labor include providing proper nutrition, promoting breastfeeding, and helping the mother manage any physical discomforts or challenges that may arise. This study investigated the level of postpartum care services delivered during the fourth stage of labor in a tertiary-level hospital in the Chitwan district of Nepal. A descriptive cross-sectional hospital-based study was conducted among 148 women …