Medical Specialties Commons^™

Treatment Of Exfoliative Dermatitis Using Homoeopathic Dilution Graphites In Lm Potency: A Case Report, K. C. Muraleedharan, Kanishka Gandhi

Indian Journal of Research in Homoeopathy

Introduction: Exfoliative dermatitis is a severe form of skin irritability that causes significant erythema and/or scaling. Most of the time, it is a secondary process, and numerous factors could contribute to the development of this widespread skin condition. Psoriasis is the most prevalent reason for exfoliative dermatitis among all dermatologic disorders. Case Summary: A 49-year-old male presented with skin exfoliation with itching, burning and pain on the whole body for 2 weeks associated with serous discharge from lesions at the back and axillae secondary to psoriasis. A single homoeopathic medication Graphites in LM potencies over two months was prescribed that …

Evaluation Of Radial Artery Anatomy With Various Anatomical Variants In Patients Undergoing Transradial Q1 Catheterization, Nisarg Desai, Sharadkumar Jain, Kunal Parwani, Pooja Vyas, Yaqub Sidatar

Journal of the Saudi Heart Association

Objectives: This study aimed to determine the incidence of radial artery anomalies in a large cohort of patients undergoing TRA and to evaluate their specific impact as predictors of procedural failure and access site complications.                                                                                  

  Methods: This prospective, observational, single-center study enrolled 1000 consecutive patients undergoing coronary angiography or intervention via TRA between 2022 and 2024. Radial artery anatomy was assessed using retrograde radial arteriography immediately following sheath insertion. Anatomical variants were categorized into high bifurcation (origin proximal to the cubital fossa), Radial artery loops (full 360-degree curvature), Tortuosity (curve of more than 45 degrees in the vessel), Narrow calliber, …

"Re-Evaluation Of Radial Artery Anatomy With Anatomical Variants In Patients Undergoing Transradial Catheterization, Eman Aslam, Eman Zahra, Maryam Amjad

Journal of the Saudi Heart Association

No abstract provided.

Evaluating The Readability Of Online Patient Education Materials For Avascular Necrosis, Gabriella B. Smith, Grady H. Hofmann, Anna V. Gussner, Nicole S. Pham, Nneoma O. Duru, Kevin G. Shea

Journal of Patient-Centered Research and Reviews

Purpose: Avascular necrosis (AVN) is a progressive pathology affecting pediatric and adult patients. Given the risks of joint collapse and surgery, patients frequently research their condition online. The average reading level in the United States is approximately the eighth-grade level. The National Institutes of Health (NIH) recommend that patient materials be written at or below a sixth-grade level. This study aimed to assess the readability and quality of online AVN resources.

Methods: A Google search using the terms “avascular necrosis” and “osteonecrosis” was conducted, and firstpage results were aggregated. Flesch-Kincaid Grade Level, Gunning Fog Index, and Flesch Reading Ease tests …

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …

Tarsal Tunnel Syndrome Due To Post-Traumatic Osseous Tunnel Formation: A Rare Case And Surgical Management, Dev Y. Patel, Eshan Doshi, Fiona Zimmerman, Jamal Revolus, Michael Kimball, Michael Franco

Cooper Rowan Medical Journal

Tarsal tunnel syndrome (TTS) is classically a compressive neuropathy of the posterior tibial nerve beneath the flexor retinaculum, presenting with plantar foot pain and paresthesias. Standard surgical management of TTS involves release of the flexor retinaculum to decompress the nerve. We report a rare and unusual case of TTS in which the posterior tibial nerve was encased within a post-traumatic osseous tunnel accompanied by dense fibrotic tissue, representing an atypical and previously undescribed etiology of nerve entrapment. In this case, surgical decompression required a modified approach involving meticulous dissection of the tibial nerve from its encasement by heterotopic ossification and …

Evaluating Medical Student Geriatric Competency Using A 5ms-Based Assessment Tool, Lauren R. Hersh Md, Amy Cunningham Phd, Mph, Xiya Wu Md

Cooper Rowan Medical Journal

INTRODUCTION

Driven by an aging Baby Boomer generation, the United States is navigating a demographic transformation with far-reaching implications that include increased demand for chronic disease management and long-term care as well as increased stress on both healthcare costs and infrastructure. Generating a workforce competent in the delivery of care to older patients with complex, multimorbid conditions is fundamental to addressing this shift. Recognizing that the development of primary and specialty care physicians skilled in geriatric care begins in medical school, the American Geriatric Society developed minimum competencies grounded in the Geriatric 5Ms (Mind, Mobility, Medication, Multicomplexity, and …

Plasma Vgf As A Predictive Biomarker For Early Acute Kidney Injury In Critically Ill Elderly Patients: A Combined Clinical And Mendelian Randomization Study, Xianyang Guo, Yu Hao, Rujie Chenn, Benji Wang, Shengwei Jin

Saudi Medical Journal

Objectives: To assess whether VGF nerve growth factor inducible (VGF) can serve as a reliable predictor of acute kidney injury (AKI) among patients requiring intensive care.
Methods: We first conducted a Mendelian randomization (MR) analysis to explore the potential causal link between plasma VGF levels and AKI risk. Subsequently, 128 critically ill individuals admitted to our intensive care unit were prospectively enrolled. Within 24 hours of either hospital admission or clinical decline, both blood and urine specimens were obtained. We measured VGF concentrations in plasma and urine, along with plasma cystatin C (pCysC), plasma and urinary neutrophil gelatinase-associated lipocalin (NGAL), …

Knowledge, Practice And Perceived Barriers Of Healthcare Provider Adherence To The Notifiable Disease Surveillance System (Ndss) In Government Hospitals And Primary Healthcare Centers In Jazan, Saudi Arabia: A Cross-Sectional Study, Moatasem F. Hakmi, Alaa Mathkour, Yousef Zahrani, Rayan I. Binduhayyim, Saad S. Alqahtani, Muhammad Z. Iqbal

Saudi Medical Journal

Objective: To assess and compare healthcare providers' understanding of the Notifiable Disease Surveillance System (NDSS), alongside reported and perceived challenges, across public hospitals and primary healthcare centers in Jazan, Kingdom of Saudi Arabia.
Methods: A cross-sectional study was conducted between 10 January 2025 and 30 December 2025 among health care providers at Jazan hospitals and primary healthcare centers (PHCs) (n = 420). Data were collected via structured self-administered questionnaire that included the following sections: demographic data, knowledge of the NDSS, reporting practices, competency of the Health Electronic Surveillance Network (HESN) and perceived barriers. Descriptive and inferential statistics were used to …

Cranial Mri In Girls With Central Precocious Puberty: Clinical Characteristics And Predictors Of Abnormal Findings, Fahad N. Al Juraibah, Mashael M. Alharbi, Reem D. Alharbi, Joud S. Albaraki, Sarah S. Aldharman, Hala A. Alghamdi, Nagarajkumar Yenugadhati, Abdullah I. Alhammad, Angham N. Almutair, Ibrahim A. Al Alwan

Saudi Medical Journal

Objectives: To describe the clinical profile of girls with central precocious puberty (CPP) and determine the factors associated with abnormal cranial magnetic resonance imaging (MRI) findings.
Methods: This retrospective study included girls aged 8 years or younger with a diagnosis of CPP who received care at King Abdullah Specialized Children's Hospital in Riyadh, Kingdom of Saudi Arabia, between 2015 and 2023. Data on clinical presentation, biochemical results, imaging findings, and treatment were obtained from medical records. Logistic regression analysis was performed to determine variables associated with MRI utilization and the occurrence of abnormal MRI findings.
Results: The cohort comprised 70 …

Thrombosis Rate And Risk Factors In Pediatric Patients With Peripherally Inserted Central Catheters, Ahmed A. Alabdulkarim, Abdullah I. Almojali, Tharaa S. Alhowaish, Dena S. Alsuhaibani, Norah I. Alshafi, Amin I. Alzahrani, Mohammed O. Alotaibi, Yousef A. Alghamdi, Hamad A. Alkhalaf

Saudi Medical Journal

Objective: To determine symptomatic thrombosis incidence in pediatric patients with peripherally inserted central catheters (PICCs) and identify associated patient and procedure-related risk factors in a tertiary pediatric center in Saudi Arabia.
Methods: We conducted a retrospective cohort study at King Abdullah Specialized Children's Hospital, Riyadh, Kingdom of Saudi Arabia, including patients aged 0–14 years who underwent PICC insertion in the Interventional Radiology department between January 2019 and June 2023. Data on demographics, comorbidities, procedural details, and outcomes were extracted from the electronic medical record system (BestCare). Symptomatic thrombosis was defined as Doppler-confirmed thrombosis with clinical signs. Associations were tested using …

Advancing Impact: A National Approach To Knowledge Translation In Saudi Arabia-The Saudi National Institute Of Health Experience, Maha M. Aleid, Manar A. Alharbi, Amal N. Almadouj, Ahmad I. Alrawaji, Lamia A. Alhaqbani, Fars K. Alanazi

Saudi Medical Journal

Objectives: To present a reproducible national model for translating research findings into evidence-based clinical practice guidelines.
Methods: The Saudi National Institute of Health launched the initiative titled ``Transforming the Outcomes of Published Health Research into Medical Guidelines that Enhance Medical Practices to Improve the Quality of Human Health'' on February 3, 2025. The initiative aimed to identify and assess research outcomes published between January 1, 2020, and December 31, 2024 across 6 predefined thematic tracks relevant to the Saudi population. Eligible publications were collected within one month after the submission portal opened. Following closure of portal, all submissions were evaluated …

Estimating Radiation Dose And Proposing Institutional Diagnostic Reference Levels For Paediatric Fluoroscopy Of Micturating Cystourethrogram: Age- And Weight - Specific Comparisons, Khalid M. Aloufi

Saudi Medical Journal

Objective: To compare age- and weight-specific methods used to estimate radiation doses and to propose institutional diagnostic reference levels (DRLs) for paediatric fluoroscopy of micturating cystourethrogram (MCUG).
Methods: In this retrospective study, MCUG fluoroscopy parameters were gathered for 100 paediatric patients from July 2025 to January 2026. The data included the MCUG paediatric procedures for patients aged 0–15 years. The data were categorized into paediatric weight- and age-specific groups. Paediatric weight-specific groups were ≤ 5, 5 < – 10, 10 < – 20, and >20 kg, and paediatric age-specific groups were ≤ 1, 1 < – 5, 5 < – 10, and < 10 – 15 years old.
Results: Differences were observed in dose area product (DAP) and DRL results for age- …

Potential Drug–Drug Interactions In Patients Undergoing Hemodialysis: A Retrospective Observational Study, Buthainah B. Al-Ammash, Fawaz A. Alharbi, Omar D. Al-Hejaili, Mansour A. Mahmoud, Mazin A. A. Abdelaziz, Alaa I. Alrais, Shahad A. Albakri, Ibrahim F. Alharbi, Sara A. Felemban, Abdullah H. Almatrafi, Salman A. Alabdali, Yaser M. Alahmadi

Saudi Medical Journal

Objectives: To evaluate the prevalence, characteristics, and determinants of potential drug–drug interactions (pDDIs) among patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) at a tertiary care hospital in Al-Madinah Al-Monawara, Kingdom of Saudi Arabia.
Methods: Data for this retrospective observational study were extracted from the electronic medical records of adult patients (≥ 18 years) diagnosed with ESRD and receiving hemodialysis (HD) between October 2022 and March 2023. The pDDIs were identified and classified using Lexicomp® (Wolters Kluwer, Alphen aan den Rijn, Netherlands). Descriptive statistics summarized patient characteristics and pDDIs, and univariate logistic regression was implemented to investigate the determinants …

Drooling In Children With Cerebral Palsy: A Narrative Review Of The Current Management Landscape, Kamel A. Alenazi

Saudi Medical Journal

Children with developmental or neurological disorders, such as cerebral palsy, present with impaired motor function, resulting in impaired swallowing, feeding, and drooling. The prevalence of chronic drooling radically changes from 0.5% in children >4 years to 60% in children with neurological ailments. Drooling can have a serious impact on the quality of life of affected children, which can create a sense of isolation and refusal by peers. In addition, drooling results in not only financial but also considerable emotional turmoil for caregivers of affected children, who are frequently confronted with difficulty managing the underlying neurological impairment of their child. In …

Scoping Review Of Mental Health Outcomes Of Cosmetic Procedures Among The Saudi Population, Hessah Alzahrani

Saudi Medical Journal

Objective: To comprehensively examine the mental health outcomes associated with cosmetic procedures among the Saudi population, with a particular focus on psychological well-being, self-esteem, anxiety, body image, and quality of life.
Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. A structured search was performed across international databases, including PubMed, PsycINFO, Scopus, Web of Science, and Google Scholar, in addition to national Arabic databases. Studies investigating the psychological outcomes of both surgical (rhinoplasty and body contouring) and …

Quality, Patient Experience, And Service Gaps In Home Healthcare In Saudi Arabia: A Systematic Review Aligned With Vision 2030, Eman Alawad, Rasha M. Mahrous, Lubna A. Elshaib

Saudi Medical Journal

Objectives: To assess the quality of home healthcare (HHC) services, patient experience, and existing service gaps in Kingdom of Saudi Arabia.
Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement. PubMed, MEDLINE, Scopus, Web of Science, CINAHL, and Google Scholar were searched for studies published between January 2011 and January 2025. Eligible studies included observational, qualitative, mixed-methods, and interventional studies conducted in Saudi Arabia that examined home healthcare quality, patient or caregiver experience, or service delivery gaps. Two reviewers independently screened studies, extracted data, and assessed methodological quality …

Implementing Diagnosis-Related Groups For Value-Based Healthcare In Saudi Arabia: A Systematic Review Of Evidence On Barriers And Facilitators, Racha M. Naim, Michelle A. Badore, Justin J. Needle

Saudi Medical Journal

Objective: To examine the barriers and facilitators to implementing Diagnosis-related groups (DRGs) in Kingdom of Saudi Arabia, aiming to identify actionable insights for policymakers and stakeholders to advance value-based healthcare (VBHC) adoption effectively.
Methods: A systematic search of bibliographic databases and relevant grey literature was conducted. Data were synthesized using the Consolidated Framework for Implementation Research (CFIR) to categorize barriers and facilitators across 5 domains.
Results: A total of 10 studies met the eligibility criteria. Key facilitators included the adoption of patient classification systems, standardized data sets, government policy support, and the availability of advanced health information systems. Barriers included …

From Bench To Bedside: Evolving Definitions Of Translational Research, Hana A. Alhumud, Fars K. Alanazi, Edward B. Devol

Saudi Medical Journal

Objective: To synthesize current evidence on the evolution, frameworks, and methodological approaches used to define and operationalize translational research, which serves as a bridge between scientific discovery and its application in clinical medicine, public health, and policy.
Methods: We systematically searched PubMed, Scopus, and Web of Science for peer-reviewed studies published up to 2023. Search terms combined translational research–related keywords (such as ``bench-to-bedside,'' ``implementation science,'' ``precision medicine'') and relevant MeSH terms. Eligible studies focused on conceptual models, frameworks, or methodological approaches related to translational research and were published in English. After duplicate removal and PRISMA-guided screening, 33 publications were included. …

Pharmacist-Led Initiative To Increase Naloxone Prescribing For Patients On High-Dose Opioids In A General Internal Medicine Clinic, Christine E. Leduc, Hyun J. Lee, Polly D. Fraga

The Lahey Journal

Abstract

Introduction:

Opioid overdose is a pressing public health concern in the United States. In 2022, prescription opioids were involved in 15% of all opioid deaths.1 Despite CDC recommendations for prescribing naloxone to high-risk patients, primary care physicians prescribe only 1.5 naloxone prescriptions per 100 prescriptions of high-dose opioids.2,3 Strategies are needed for healthcare institutions to expand naloxone access and mitigate opioid-related harm. This pilot study assesses the impact of a pharmacist-led quality improvement patient outreach initiative on increasing naloxone prescribing for adult patients taking ≥ 50 MME per day of prescription opioids as recommended by current CDC guidelines.

Methods: …

Strengthening The Evidence Base For Pediatric Cardiac Ct: Statistical And Technological Considerations, Faizan Faisal

Journal of the Saudi Heart Association

No abstract provided.

Comments On The Letter: Strengthening The Evidence Base For Pediatric Cardiac Computed Tomography: Statistical And Technological Considerations, Lamia Ghazi Jamjoom, Razan Kamal Daghistani

Journal of the Saudi Heart Association

No abstract provided.

Pola Rujukan Penyakit Saluran Pernapasan Di Fasilitas Kesehatan Tingkat Pertama: Tantangan Gatekeeper Program Jaminan Kesehatan Nasional Di Jakarta, Syarif Rahman Hasibuan, Melrose Holy Natasha, Fatih Jihadi Ramadan

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Program Jaminan Kesehatan Nasional yang diselenggarakan oleh Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan mewajibkan Fasilitas Kesehatan Tingkat Pertama (FKTP) untuk menyeleksi kasus yang memerlukan rujukan. Penyakit saluran pernapasan yang menjadi penyebab utama kunjungan ke FKTP memiliki pola rujukan yang masih belum banyak diteliti. Oleh karena itu, dilakukan penelitian untuk melihat pola rujukan penyakit saluran pernapasan di FKTP dan mengetahui faktor yang berasosiasi dengan keputusan rujukan. Penelitian potong lintang ini dilakukan terhadap 89.225 klaim FKTP di Jakarta pada periode 2017-2023, dengan kriteria inklusi semua kunjungan dengan diagnosis ICD-10 diseases of the respiratory system. Uji regresi logistik dilakukan untuk mengidentifikasi faktor …

Acute Liver Injury Likely Induced By Alpha Lipoic Acid Contained In Dietary Supplement, Simona Maksimyan, Jonathan V. Reyes, Kasim Kazbay, Farah K. Gazi

Journal of Community Hospital Internal Medicine Perspectives

The rise in use of herbal and dietary supplements, which are regulated as food rather than as drugs by the Food and Drug Association, poses the risk of unknown and potentially severe side effects. We describe the case of acute liver injury, characterized by significant elevation in AST and ALT, likely induced by the consumption of an over-the-counter supplement containing alpha lipoic acid (ALA). Our patient trusted in a “natural” alternative to Western medicine for management of neuropathy, which was ultimately detrimental to her liver. An immediate and sustained improvement in liver enzyme levels was noted with discontinuation of the …

The High Cost Of Incomplete Physical Exams: Missed Diagnosis Of Cushing Syndrome In A Patient With Recurrent Hospital Admissions, Tarah M Burton, Miranda K Hunter, Mihail Zilbermint

Journal of Community Hospital Internal Medicine Perspectives

Cushing syndrome is a rare but life-threatening endocrine disorder associated with a classic constellation of physical exam findings (e.g. “moon facies”, abdominal striae, etc.). However, thorough biochemical testing is needed to confirm this diagnosis. We present the case of a 35-year-old male with multiple hospitalizations across a variety of healthcare institutions for heart failure, cellulitis, uncontrolled hypertension, and diabetes.  While an adrenal mass was eventually identified on imaging, classic signs of Cushing syndrome – including violaceous striae, truncal obesity, and facial plethora – were missed during prior admissions.  This case illustrates the diagnostic delay that can result from incomplete physical …

Clinical And Laboratory Predictors Of 30-Day Mortality In Hiv-Positive Adults With Pneumonia: A Prospective Observational Study From North India, Mandip Singh Bhatia, Ankita Kumari Bhargav, Saurabh Chandrabhan Sharda, Shankar Naidu, M. R Shivaprakash, Sunil Sethi, Vikas Gautam, Arnab Ghosh

Journal of Community Hospital Internal Medicine Perspectives

Background: Pneumonia remains a major cause of morbidity and mortality among people living with HIV (PLHIV), particularly in low- and middle-income countries. Despite the availability of antiretroviral therapy (ART), early mortality after hospitalization for pneumonia remains high. Indian data on short-term mortality predictors in HIV-associated pneumonia are limited.

Methods: We conducted a prospective observational study of HIV-positive adults admitted with pneumonia to a tertiary-care hospital in North India between April and December 2025. Clinical, laboratory, microbiological, and radiological parameters were recorded at admission. Patients were followed for 30 days. The primary outcome was all-cause 30-day mortality. Predictors of …

Low Rates Of Smoking Cessation Medication Prescriptions And Evidence To Support Increased Medication Utilization, Jesse Pratt

SIU Journal of Medical Science Scholarly Works

ABSTRACT

Introduction: Tobacco use remains a major cause of morbidity and mortality in the United States.  Over the past several decades, there has been a steady decline in tobacco use, however overall use remains unacceptably high.  Despite recommendations to treat people with tobacco use disorder with smoking cessation medications (SCMs), prescriptions for SCMs remain low.

Methods: A PubMed search was conducted using search terms “adult”, “smoking cessation”, “medication”, “varenicline”, “nicotine”, and “bupropion”.  Filters included publication dates within ten years, and full text.  Search results yielded 109 articles.  Thirteen articles were selected for the review.  The articles chosen either discussed prescribing …

The Impact Of A Modified Hospital Elder Life Program On Delirium, Ashley Okray

SIU Journal of Medical Science Scholarly Works

Background: Delirium, an acute state of fluctuating inattention and cognitive impairment, is prevalent among hospitalized older adults and associated with longer hospital stays, increased mortality, and significant healthcare costs. The Hospital Elder Life Program (HELP) was developed to reduce delirium through interventions addressing common risk factors. Although HELP has proven effective, many hospitals face challenges in implementing the program, leading to modified versions. This review examines recent studies using modified HELP to assess their impact on delirium prevention.

Methods: A literature search was conducted to identify studies from the last ten years that implemented modified HELP programs. Relevant studies …

Preoperative Urine Drug Screen To Increase Surgical Efficiency, Joseph Mashinchi

SIU Journal of Medical Science Scholarly Works

Purpose: The purpose of this article is to standardize the use of preoperative urine drug screens for adults scheduled for elective surgery in order to improve surgical efficiency and reduce perioperative and postoperative complications.

Method: A PubMed Search was conducted to review literature published within the past five years. The joint terms “urine drug screen and surgery” were used in the search. A literature review was conducted after reviewing multiple articles and screening for their quality, timeliness, and pertinence to elective surgical procedures and illicit drug use.

Results: Performing a urine drug screen prior to elective surgical procedure identified illicit …

Preparation Of Physician Assistant Students To Manage Patients Living With Hiv/Aids In A Primary Care Setting, Austin Parrish

SIU Journal of Medical Science Scholarly Works

This study examined Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), Pre-Exposure Prophylaxis (PrEP), and Post-Exposure Prophylaxis (PEP) educational exposure among clinical-phase physician assistant (PA) students and evaluated how well current curricula prepare future providers for HIV prevention and care. A cross-sectional survey of 109 PA students assessed HIV-related knowledge, clinical exposure, and awareness of key public health concepts, while lecture materials from 30 PA programs were analyzed for curricular content. Students demonstrated moderate but incomplete baseline knowledge, and fewer than one-quarter reported observing PrEP prescribing during primary care rotations. Awareness of Undetectable = Untransmittable (U=U) was limited, with only …