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Reinforcing Malaysian Public Sector Excellence: The Impact of Islamic Work Ethics on Task and Contextual Performance
No full textIn Malaysia, the government has long advocated for performance measurement initiatives as part of a broader agenda to improve the efficiency and quality of public service delivery. Despite significant investments in capacity-building, policy reforms, and institutional frameworks, the public sector continues to face scrutiny over service inefficiencies and a limited understanding of citizen needs. Previous initiatives have primarily aimed at enhancing technical skills and knowledge. However, there is an increasing acknowledgment that ethical values and work attitudes are equally vital for fostering high performance. This study explores the impact of Islamic work ethics on work performance, specifically focusing on both task and contextual performance among employees in the Malaysian public sector. Data were gathered from 174 civil servants using a combination of drop-and-collect and mail survey methods, and the responses were analyzed using partial least squares structural equation modeling (PLSSEM). The results indicate that Islamic work ethics has a significant positive effect on both task and contextual performance, highlighting the critical role of ethical orientation in public administration. These findings not only enhance the theoretical understanding of work ethics within an Islamic context but also provide practical implications for public sector reform, particularly in developing values-based human resource strategies
Pseudoscience Institutionalization: A New Challenge for HIV/AIDS Healthcare Service Institution in the Era of Social Media Disruption
No full textSocial media becomes a new space for people to interact with each other. Social change occurring in digital era distributes power to social media users. This condition represents the distribution of freedom and power of speech to everyone, instead of them being concentrated in large media corporations. On the other hand, it potentially creates harmful pseudoscience such as opinion manipulation and hoaxes, which are also true about health discourse. Consequently, social media instead becomes a new challenge for HIV/AIDS healthcare service institutions as it has implication regarding the stigmas against people living with HIV/AIDS (PLWHA). This research is carried out to explore the institutionalization of pseudoscience in the era of social media disruption using Michel Foucault’s knowledge as power perspective. The research was conducted using qualitative method and exploratory approach in Surakarta City, Sukoharjo Regency, and Boyolali Regency, Indonesia. Data were collected through focus group discussions, in-depth interviews, observation, and documentation. The informants were, among others, employees of the Health Office, physicians, Puskesmas service staff, administration staff, patients, non-government organizations (NGOs), and PLWHAs in the three cities. The results of research show that social media has implication on the production of pseudoscience, leading to an increase in discussions related to HIV/AIDS. Knowledge represented through content of social media produces power for the creators to rule the netizen. This mixes scientific and fake information in social media discourse. Healthcare services in Surakarta City, Sukoharjo Regency, and Boyolali Regency were disrupted by social media resulting in new challenges. Therefore, strategic plans and policies are required to accommodate to the new risks created by the presence of social media through the application of humanistic digital practice concept
Potency of oral gonadotropin-releasing hormone antagonist as endometriosis-associated pain novel treatments: An updated meta-analysis of randomized controlled trials
No full textBackground: Elagolix, Linzagolix, and Relugolix, as oral gonadotropin-releasing hormone antagonists, have emerged as promising treatments for endometriosis-associated pain.
Objective: To evaluate pain intensity reduction as the primary outcome and assess side effects and quality of life as secondary outcomes through an updated meta-analysis.
Materials and Methods: A systematic search was conducted in Cochrane, Scopus, and PubMed/Medline. Study quality was assessed using the Cochrane risk of bias in non-randomized studies of interventions tool. The pooled standard mean difference and p-value were calculated using a random-effects model (DerSimonian-Laird method), and the inconsistency index was applied to evaluate heterogeneity.
Results: 7 randomized controlled trials were included. Gonadotropin-releasing hormone antagonists significantly reduced dysmenorrhea, dyspareunia, and non-menstrual chronic pelvic pain when measured with the verbal and numeric rating scales, but not with the modified Biberoglu and Behrman score. Secondary outcomes showed significant improvements in health status (endometriosis health profile and patient global impression of change). However, treatment was associated with increased hot flushes (3.61-fold higher), an 8.96% increase in low-density lipoprotein after 6 months, and a rise in high-density lipoprotein compared with placebo. Bone mineral density in the spine was significantly lower in the treatment group (p < 0.001).
Conclusion: This meta-analysis provides updated evidence on Elagolix, Linzagolix, and Relugolix, confirming their effectiveness in managing endometriosis-associated pain, while highlighting important considerations regarding metabolic and bone health
Impact of intrauterine infusion of human chorionic gonadotropin and hyaluronic acid enriched medium on pregnancy outcomes in frozen-thawed cycles with recurrent implantation failure: An RCT
No full textBackground: Recurrent implantation failure in assisted reproductive technology is a major challenge. Intrauterine human chorionic gonadotropin (hCG) infusion and hyaluronic acid enriched embryo transfer media have shown individual effects, but their combined effect in these cases undergoing frozen-thawed embryo transfer is unknown.
Objective: This study aims to investigate the effect of combined therapy on pregnancy outcomes.
Materials and Methods: This is a single-blind, randomized controlled trial on 158 participants. The cases were randomly assigned to either the intervention group (pretransfer intrauterine hCG infusion and embryo loaded with hyaluronic acid-enriched embryo transfer medium at the time of transfer) or the control group (standard embryo transfer medium). The outcomes were chemical and clinical pregnancy rates, implantation, abortion, and ongoing pregnancy rates.
Results: A total of 158 participants were enrolled in this study in 2 equal groups. The intervention did not significantly improve the overall pregnancy rate compared to control (24% vs. 33.7%, p = 0.30). The results showed that, by controlling variables, the chance of clinical pregnancy in the intervention group was 12% lower than in the control group, although the difference was not statistically significant (p = 0.879). With each increase in the number of embryos, the chance of a pregnancy would be 2.26 times higher. Also, the chance of pregnancy in the morula stage was 68% lower than in the cleavage stage (p < 0.05).
Conclusion: The combined approach of intrauterine hCG infusion and the hyaluronan-enriched embryo transfer medium did not significantly improve the overall pregnancy rate but had a significant effect on specific cases using the embryo at the cleavage stage for transfer and cases that received more than one embryo for transfer
Investigation of a novel absorbable protein stent for microsurgical vasovasostomy in rats: An experimental study
No full textBackground: Microsurgical 2-layer vasovasostomy is a commonly used technique to treat vasal obstruction in male infertility, and optimizing the surgical approach has important clinical implications.
Objective: To compare the differences between stent-assisted vasovasostomy and the conventional technique in terms of operative time, vasal patency rate, and reproductive function.
Materials and Methods: This experimental study included 54 male Sprague-Dawley rats (8–9 wk, 300 ± 15 gr) and 12 female rats (7–8 wk, 250 ± 13 gr, used for co-housing experiments). The male rats were randomly assigned to 3 groups (n = 18/each): control groups, conventional groups, and stent groups. Postoperative assessments were performed at 2, 5, and 8 wk, including operative time, vasal patency rate, morphological changes (such as epithelial integrity and granuloma formation), immune response (serum immunoglobulin G and anti-sperm antibodies), and reproductive function (semen quality, pregnancy rate, and reproductive hormone levels).
Results: The average operative time in the stent group was significantly shorter than in the conventional group (28.8 ± 5.2 min vs. 70.4 ± 4.0 min, p < 0.001). The vasal patency rates were 100% and 91.7%, and the pregnancy rates were 83.3% and 75.0% in the stent-assisted and conventional groups, respectively. No statistically significant differences were observed between the 2 groups in terms of immune response (serum immunoglobulin G, anti-sperm antibodies), semen parameters, or reproductive hormone levels. Histological examination showed that most anastomotic sites exhibited good structural integrity without marked inflammation, with only one rat showing mild granuloma formation.
Conclusion: The absorbable protein stent shortens the operative time of vasovasostomy while maintaining favorable patency and reproductive outcomes. It shows promising potential for optimizing microsurgical vasovasostomy in clinical practice
N-terminal pro-B-type natriuretic peptide levels in pregnant women with heart disease and complications: A cohort study
No full textBackground: Heart diseases affect 1–4% of pregnancies, leading to fetomaternal complications. Brain natriuretic peptide is a key biomarker for assessing cardiac adaptation to pregnancy-related hemodynamic changes. The longer half-life of its terminal fragment, N terminal pro brain natriuretic peptide (NT-ProBNP), increases its diagnostic utility.
Objective: This study aimed to evaluate the association between NT-proBNP serum levels and fetomaternal complications in pregnant women with cardiovascular disease.
Materials and Methods: A prospective longitudinal study was conducted at the Cardiology and Obstetrics Clinic of Imam Reza hospital, Mashhad, Iran, from July 2019-July 2020. 50 pregnant women in their third trimester with cardiovascular disease (New York Heart Association class 2 or higher) were included. Based on NT-proBNP levels, participants were categorized into normal (n = 37) and elevated (n = 13) groups using a 125 pg/ml cutoff. Fetomaternal complications were assessed and analyzed.
Results: Elevated NT-proBNP levels were significantly associated with increased hypertension in the second (p = 0.05) and third (p < 0.0001) visits and low Apgar scores (p = 0.05). A significant difference in drug history (p = 0.013) was observed between the groups. However, no significant differences were found in other variables, including intensive care unit)/neonatal intensive care unit admission, mode of delivery, electrocardiography findings, or echocardiographic results (p > 0.05).
Conclusion: Elevated NT-proBNP levels are strongly linked to hypertension during pregnancy and low neonatal Apgar scores, highlighting its potential as a predictive biomarker for fetomaternal risk assessment
The Effect of Tinted Filters on the Visual Function of Patients with Retinitis Pigmentosa
No full textPurpose: To investigate the effect of tinted filters on contrast threshold (CT) and visual evoked potentials (VEPs) in patients with retinitis pigmentosa (RP).
Methods: In this cross-sectional study, RP patients with best corrected visual acuity better than 1 log MAR were evaluated. The CT was measured using the Freiburg Acuity and Contrast Test, and pattern reversals were analyzed for both time and frequency components. The effects of gray (15% light transmission, 410 nm cutoff), brown (18% light transmission, 410 nm cutoff), and yellow (27% light transmission with a 470 nm cutoff) tinted filters were evaluated and compared.
Results: Eighteen participants (mean age 32.78 ± 7.35 years; 72.2% male) were evaluated. The mean CT of Weber was 3.46 ± 3.2%. Yellow filters decreased CT (mean difference [MD]: –0.597%, P = 0.054). Brown filters did not produce a significant change in the CT (MD: 0.233%, P = 0.620), while the gray filters caused a significant increase in the CT (MD: 1.423%, P = 0.004). Mode frequency (Fmod) decreased with gray filters (MD: –2.33%, P = 0.004). The latency and amplitude of VEPs improved with yellow filters (P < 0.05) but worsened with gray filters (P < 0.05). Additionally, the spherical equivalent showed an inverse correlation with CT in patients with RP (r = –0.997, P < 0.001).
Conclusion: Using tinted filters as a low-vision aid can modify contrast sensitivity and both frequency and time domains of VEPs in patients with RP. Yellow filters appear to improve visual function, whereas gray filters may worsen it
Retinal and Choroidal Metastasis from a Lung Carcinoid Tumor
No full textThis is an Photo Essay and does not have an abstract. Please download the PDF or view the article in HTML
Hyperreflective Choroidal Foci: A Comprehensive Review
No full textHyperreflective choroidal foci (HCF) are a finding on optical coherence tomography that may serve as a biomarker in various retinal and choroidal pathologies. These discrete hyperreflective spots, identified in various layers of the choroid, have been linked to inflammatory, vascular, and degenerative conditions. This review examines the clinical significance, histopathological correlation, and implications of HCF in various diseases, including diabetic retinopathy, age-related macular degeneration, Stargardt disease, choroideremia, Vogt-Koyanagi-Harada disease (VKH), idiopathic posterior uveitis, retinitis pigmentosa, and central serous chorioretinopathy (CSR), as well as non-pathological states. Although further studies are required to validate the findings in each pathology described herein, HCF may be used as a background prognostic marker of disease progression and therapeutic response, albeit with caution
The Effect of Service Quality on Patient Satisfaction, Happiness, and Loyalty in Primary Healthcare Centers in the United Arab Emirates: A Cross-sectional Study
No full textIntroduction: The United Arab Emirates has proven its lead position in modern healthcare delivery and is considered an important medical tourism destination in the region. Government and public institutions have the opportunity to distinguish themselves in a competitive industry by providing outstanding and superior healthcare services. Enhancing patient care has become a paramount focus for all healthcare service providers, aiming to achieve high levels of patient satisfaction as their ultimate goal.
Aim: The study aimed to determine the level of satisfaction, happiness, and loyalty among patients attending primary healthcare centers (PHCCs) and finding the factors that lead to improved patient satisfaction.
Method: A self-administered survey was used to conduct this cross-sectional study in six main PHCCs that covers different Emirates in the United Arab Emirates and included 350 participants.
Results: The study revealed that 82% of patients reported feeling happy after receiving care at the center, while 86% expressed high satisfaction with the primary healthcare (PHC) services. Additionally, 81% of patients demonstrated loyalty by maintaining trust in the PHC staff and returning to the center for future medical care. A strong correlation was observed between patient satisfaction and their level of happiness with the healthcare services provided, which, in turn, was significantly linked to loyalty, reinforcing trust and preference for future care.
Conclusion: Using data from this study as a baseline to improve services in future is crucial since the patient’s perspectives and their voices are increasingly influential in enhancing health care delivery system