European Journal of Medical and Health Research
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A Literature-Based Review of Control Infection Practices of Healthcare Workers in Rural Health Facilities
No full textHealthcare workers who are at the frontline of infection prevention and control, often get caught up in a dilemma in rural health facilities that reflect complex interactions between knowledge, attitude, and institutional realities. This study synthesized literature that explores how these practices informs infection control outcomes in low-resource rural settings. Evidence from diverse studies revealed that while awareness of infection control guidelines is generally high, consistent adherence remains suboptimal, largely due to infrastructural deficits, inadequate training, and attitudinal factors. Many healthcare workers demonstrate positive attitudes toward standard precautions, but this often does not translate into sustained practice, especially where supply chain weaknesses or managerial oversight are lacking. The findings further indicates that organizational culture, perceived risk, and social norms significantly influence compliance levels, suggesting that infection control is as much a behavioral issue as it is procedural. The Health Belief Model (HBM) provided a theoretical framework for understanding how these gaps shape healthcare workers adoption of infection control measures. The model underscores that even in the presence of adequate knowledge, behavior change is contingent upon belief systems and environmental factors. Accordingly, this study advocated for integrated strategies that combine technical training with behavioral and institutional interventions, especially in resource-constrained rural areas
Efficacy and Safety of Autologous Fat Grafting for Breast Reconstruction Following Partial Mastectomy in Iraqi Women with Early-Stage Breast Cancer: A Prospective Clinical Evaluation
No full textBackground: Among women in Iraq, breast cancer is still the most common oncologic burden; the increase in incidence of the disease is attributed to late diagnosis and unavailability of screening. Whereas breast-conserving surgery (BCS) with radiotherapy is the best choice in the early stages of the disease, it tends to leave contour deformities which has an immense impact on body image, psychosocial well-being and social integration which are of increased importance in the cultural context of Iraq. Autologous fat grafting (AFG) has been shown to be an internationally recognized form of reconstructive surgery, which is minimally invasive and biocompatible, but its use and effects in prospective research have not been studied in the Middle East, especially in Iraq. Objective: To compare the effectiveness, safety, patient-reported satisfaction and oncologic compatibility of AFG in partial breast reconstruction used by Iraqi women after BCS and adjuvant radiotherapy. Methods: The study was a 12-month prospective cohort study that was carried out at the Ghazi Al-Hariri Hospital of Surgical Specialties, Baghdad Medical City (January 2022-December 2023). It enrolled 42 women (25 to 65 years of age) with Stage I- II breast cancer who had undergone partial mastectomy and radiotherapy completed 6 months ago. Tumescent liposuction of the abdomen or thighs was performed and adipose tissue harvested, centrifuged with the Coleman technique, and injected into the breast defect in a number of tissue planes. The key outcomes were fat retention at 12 months (measured with the use of 3D stereophotography) and BREST-Q satisfaction scores. The secondary outcomes included complication rates, radiologic findings, and oncologic events. Results: The average injected volume of fat per breast was 85.3 ± 22. 7 mL and the mean retention rate was 68.4% ± 9.3% at 12 months. BREAST-Q scores showed significant improvement: The level of satisfaction with Breasts grew 42.1 8.9 to 81.3 10 and Psychosocial Well-being went 39.5 7.6 to 78.9 9.8 (both of which are above the minimal change of 10 points). The 100 complications were not severe and far between: oil cysts (4.8%), fat necrosis (2.4%), benign calcifications (9.5%), and minor asymmetry (7.1%). There were no infections, graft loss that had to be treated, or morbidities of the donor-site. Radiologic assessment showed no BI-RADS 4 and 5 lesions that could be related to grafting. Notably, there were no local recurrences; distance metastasis was present in a patient with aggressive triple-negative disease, which was considered to be not related to AFG at multidisciplinary tumor board. Conclusion: The present prospective study is the first study in Iraq that proves that AFG is a safe, effective, and culturally congruent means of breast reconstruction following BCS. It results in high patient satisfaction, predictable retention of volume, and no oncologic compromise either when
 
Machine Learning Models for Predicting Neurodegenerative Disease Onset in Population Cohorts: A Public Health Analytics Perspective
No full textThe problem of neurodegenerative diseases is becoming a growing international issue of contemporary public health, and its multifactorial and preclinical development makes its early detection a significant obstacle, which requires novel analytic methods beyond conventional statistical modelling. The research was carried out to construct, test, and explain machine learning (ML) models capable of predicting the onset of neurodegenerative disease using a vast population cohort in a longitudinal study, incorporating demographic, clinical, biomarker, lifestyle, and environmental exposures. A retrospective cohort design was used, with evaluation based on electronic health records, biospecimens, behavioural measures, and environmental data, which were analysed using logistic regression, random forests, XGBoost, lightgbm, SVM, and deep survival models. XGBoost achieved the best performance, with the highest discriminative performance (AUC = 0.864), best calibration (Brier score = 0.112), and best net clinical benefit across all risk levels. The SHAP analysis indicated that age, APOE ε4 genotype, systemic inflammation (CRP), low physical activity, and PM2.5 exposure were the most strongly associated predictors, supporting key theoretical explanations such as the neuroinflammation hypothesis, the cognitive reserve theory, and exposome models. Survival modelling also indicated that APOE 4 carriers and people with increased CRP developed the disease much more quickly, whereas greater physical activity slowed its progression. To sum up, explainable ML models can provide valuable, interpretable solutions for precise public health by identifying individuals at high risk before clinical expression. It is suggested to integrate ML risk stratification into screening programmes, enhance efforts to address modifiable risks, including physical inactivity, vascular/metabolic risk, and pollution exposure, and develop robust ethical protections for the utilisation of genetic and longitudinal health information by health systems
A Descriptive Study to Access the Level of Knowledge Regarding Migraine among Undergraduate Nursing Students at Selected Colleges of Bengaluru
No full textMigraine is a common neurological disorder that affects a large proportion of the adult population worldwide and has significant implications for quality of life and academic performance, especially among students in healthcare professions. The present descriptive study was conducted to assess the level of knowledge regarding migraine among undergraduate nursing students at Smt. Nagarathnamma College of Nursing, Bengaluru. A quantitative research approach with a descriptive research design was adopted. A total of 90 undergraduate nursing students were selected using a purposive sampling technique. Data was collected using a self-structured questionnaire to assess baseline variables and knowledge regarding migraine. Descriptive and inferential statistics were used to analyze the data. The results revealed that 5.6% of students had poor knowledge, 62.2% had average knowledge, and 32.2% had excellent knowledge regarding migraine. A significant association was found between knowledge levels and selected variables such as gender, mother’s education, and participation in migraine-related classes, whereas no significant association was observed with other variables including area of residence, type of family, father’s education, presence of healthcare workers in the family, family history of migraine, diagnostic history of migraine, exposure to information sources, and experience caring for migraine patients. The findings indicate that while most students have moderate knowledge, targeted educational programs could enhance understanding of migraine and its management among nursing students
An Exploratory Study to Evaluate the Knowledge Regarding Organ Donation among 4th Year B.Sc. Nursing Students at Smt. Nagarathnamma College of Nursing, Bangalore
No full textThis study aimed to evaluate the effectiveness of a structured teaching programme on knowledge regarding organ donation among fourth-year B.Sc. Nursing students at Smt. Nagarathnamma College of Nursing, Bengaluru. A quasi-experimental one-group pre-test post-test design was adopted, involving 30 students selected through purposive sampling. Data were collected using a structured questionnaire administered before and after the intervention. Findings revealed that in the pre-test, 26.7% of students had inadequate knowledge, while 73.3% demonstrated moderate knowledge. After the intervention, 96.7% of students attained adequate knowledge, and only 3.3% remained at a moderate level. The mean post-test score (20.47) was significantly higher than the pre-test score (8.67), with a paired t-test value of -22.155 (p < 0.000), indicating substantial improvement. No significant associations were observed between knowledge scores and demographic variables such as gender, income, residence, or health status, suggesting that the teaching programme itself accounted for the knowledge gains. The findings highlight the critical role of structured educational interventions in bridging knowledge gaps and promoting awareness of organ donation among nursing students. The study concludes that incorporating structured teaching on organ donation into nursing curricula could strengthen students’ competence and positively influence community awareness. Further large-scale research is recommended to validate these results across diverse educational and cultural settings
A Study to Determine the Effectiveness of Planned Teaching Programme on Knowledge Regarding Sudden Infant Death Syndrome among Third Year B.Sc. Nursing Students at Selected Nursing College, Bengaluru
No full textThis quasi-experimental study evaluated the effectiveness of a structured
teaching programme on knowledge regarding Sudden Infant Death Syndrome (SIDS) among third-year B.Sc. Nursing students at SMT Nagarathnamma College of Nursing, Bengaluru. A total of 60 students were selected using a non-probability purposive sampling method. A pre- test/post-test design was employed to assess changes in knowledge. Pre- test scores ranged from 7 to 31, with a mean of 16.58±6.66 (51.81%). After the teaching intervention, post-test scores significantly improved, ranging from 15 to 32 with a mean of 28.55±3.67 (89.22%). A paired t-test analysis showed a statistically significant difference between pre- and post-test scores (t(59) = 14.93, p < 0.000), confirming the effectiveness of the programme. Post-test data revealed that only 1.7% of participants remained in the inadequate knowledge category, 8.3% demonstrated moderate knowledge, and 90% achieved adequate knowledge. These results highlight the value of structured educational programme in enhancing nursing students’ understanding of SIDS. The study underscores the importance of targeted teaching strategies in raising awareness and promoting preventive knowledge related to child health, thereby contributing to improved health care outcomes through better- informed future professionals
Determinants of Post Stroke Quality of Life: Experiences from a Physiotherapy Unit Clinic, South-South, Nigeria
Full text linkIntroduction: Stroke is a prevalent cardiovascular system event particularly among people of African descent anywhere in the world. The impact of stroke on the life of survivors is multifaceted affecting their quality of physical, mental and social life. In the last four decades, studies reveal that stroke incidence in low- and middle-income countries such as Nigeria have witnessed a double increment in incidence whereas in high-income countries this has declined by over 40% within the same time period. This study aimed to examine the quality of life of stroke survivors in Nigeria and understand the factors that contribute to good quality of life among them.Materials and Methods: In this descriptive cross-sectional study, participants were recruited during physical rehabilitation sessions at two tertiary hospitals in South-South Nigeria. Exclusion criteria included, prior transient ischemic heart attack, recurrent persistent deficit, underlying psychotic and mental disorders, cognitive impairment and those who were handicapped before the stroke event. Tools used for the study were a semi-structured questionnaire and the Stroke Impact Scale (SIS 3.0) which measured the quality of life among stroke survivors. Data were analyzed using both descriptive and inferential statistics. Significance was set at P≤0.05.Results: Most of the respondents (54%) fell within the 56-65years age group with mean age at 59.0(SD = ±9.12). The proportion of the average raw score to the total raw score of all the domains and total quality of life score were all above 50%. The emotions domain had the highest proportion of average to highest possible scores (91%). Analysis of variance (ANOVA) between, socioeconomic and demographic factors, clinical factors and home care on the quality of life of the stroke participants were done to find their association. Age (F = 4.9(P =0.001) and marital status (F = 4.28(P =0.007) the side of lesion (F=8.17; P =0.005), having a previous stroke (F=8,08(P =0.005), the type of stroke (F = 11.37; P =0.001) and all aspects of the at home care with the exception of the hospital payment (F=1.73; L P =0.165) were significantly associated with quality of life. Gender F=3.54(P =0.070) and employment status F = 4.28; P =0.137), diabetes and hypertension had no effect on the quality of life of the patients.Conclusion: The quality of life among stroke survivors in this study, was above average. Spousal support, higher educational qualification, ischemic stroke, were positively associated with good quality of life of stroke survivors in our locality. This study adds to the growing body of research on QOL among stroke survivors within the country. This result will also minimize the gap in evidence-based research on the quality of life of stroke patients, particularly in the South-South region of the Nigeria
Assessing Medical Imaging Students’ Knowledge of Radiation Protection and Curriculum Coverage in Palestinian Universities
Full text linkThe understanding of radiation protection among workers in radiography fields can significantly influence their conduct during work, thus affecting the standard of medical care. This research examines the knowledge of Ionized Radiation Protection (IRP) among medical imaging students in Palestine and evaluates the coverage of radiation protection topics in their study curriculum. A cross-sectional study was conducted involving medical imaging students from four Palestinian universities. 128 students participated by completing a well-designed questionnaire. The study sample comprised masters, fourth-year, and third-year bachelor's students from medical imaging departments at Palestinian universities, with a response rate of 91.4%. The participants exhibited adequate overall knowledge regarding radiation protection safety, with a mean score of 3.49. However, their understanding of modern imaging procedures was found to be unsatisfactory. Many participants expressed the belief that the level of radiation protection education they received was insufficient. Additionally, most Palestinian medical imaging students reported that their university curriculum lacked coverage of modern radiography topics such as PET scan, fluoroscopy, and nuclear medicine, with mean perception scores of 2.61, 2.69, and 2.81, respectively. Students at lower educational levels demonstrated lower levels of knowledge about IRP. Lack of specialized knowledge between medical imaging students regarding IRP could adversely affect their future professional requirements. Therefore, it is crucial for decision-makers in Palestinian universities and the health sector to develop new strategies aimed at enhancing awareness and knowledge of IRP through targeted training programs. Further research expanding on this study is recommended to explore these issues in greater depth.The understanding of radiation protection among workers in radiography fields can significantly influence their conduct during work, thus affecting the standard of medical care. This research examines the knowledge of Ionized Radiation Protection (IRP) among medical imaging students in Palestine and evaluates the coverage of radiation protection topics in their study curriculum. A cross-sectional study was conducted involving medical imaging students from four Palestinian universities. 128 students participated by completing a well-designed questionnaire. The study sample comprised masters, fourth-year, and third-year bachelor's students from medical imaging departments at Palestinian universities, with a response rate of 91.4%. The participants exhibited adequate overall knowledge regarding radiation protection safety, with a mean score of 3.49. However, their understanding of modern imaging procedures was found to be unsatisfactory. Many participants expressed the belief that the level of radiation protection education they received was insufficient. Additionally, most Palestinian medical imaging students reported that their university curriculum lacked coverage of modern radiography topics such as PET scan, fluoroscopy, and nuclear medicine, with mean perception scores of 2.61, 2.69, and 2.81, respectively. Students at lower educational levels demonstrated lower levels of knowledge about IRP. Lack of specialized knowledge between medical imaging students regarding IRP could adversely affect their future professional requirements. Therefore, it is crucial for decision-makers in Palestinian universities and the health sector to develop new strategies aimed at enhancing awareness and knowledge of IRP through targeted training programs. Further research expanding on this study is recommended to explore these issues in greater depth
Effect of Oral Consumption of Essential Amino Acids Supplement on Growth Hormone Level in Healthy Individuals Under 18 Year-Old
Full text linkBackground: Oral essential amino acid (EAA) ingestion is popular due to its potential growth and health advantages. The body cannot synthesise these amino acids, so they must be ingested for protein synthesis, muscle repair and metabolic function, which are essential for physiological functions, especially development in children and adolescents. The aim of this study was to investigate the effects of oral EAA on GH levels in healthy children under 18 years of age and to demonstrate its potential as a dietary intervention for adolescent growth. Methods: Essential amino acids (EAA) were tested on growth hormone (GH) levels in healthy under-18s using a randomised, blinded, controlled approach. Each 50-person EAA supplementation and control group was gender balanced. Females in the EAA group had higher GH levels than males, while females in the control group had lower GH levels. Post-supplementation GH levels were not significantly correlated with age, showing that age does not influence the response to EAA supplementation. Results: The 100-person, sex-balanced study compared amino acid supplementation and a placebo on growth hormone (GH) levels. Amino acid supplementation significantly increased GH levels (P=0.0001), whereas placebo slightly increased GH levels (P=0.005). GH levels were higher in women than in men in the placebo group (P=0.047), but supplementation did not affect the age-GH association (R=-0.17, P=0.2). Conclusions: This study demonstrated a significant increase in growth hormone (GH) in the amino acid class, particularly in females, suggesting that there may be sex differences in the way GH is regulated. The results show that increasing lysine and tryptophan in these areas may have a beneficial effect on growth
Multilevel Thoracic Spinal Epidural Hematoma: Emergency Surgery or Conservative Treatment? A Rare Case Report
Full text linkBackround. Spinal epidural hematoma is a rare condition that can occur either spontaneously or as a result of trauma. The causes and factors influencing outcomes remain controversial. Rapid diagnosis and surgical evacuation of the hematoma are critical for effective treatment.Study design.A case reportCase presentation. A 78-year-old female patient was hospitalized with complaints of knee pain.Two days after the patient's prosthesis surgery, acute paraplegia was detected in the lower extremity during the mobilization process. In the thoracal magnetic resonans images,a compression fracture in the middle and anterior part of the T4 vertebral body and a spinal epidural hematoma extending from the T4 vertebral level to the L1 vertebral level was detected and urgent decompressive laminectomy was performed. Postoperative 24-hour, first-month, and sixth-month follow-ups were performed and motor recovery was observed. She was seen swimming and walking without any help.Conclusion. Although the management of spinal epidural hematoma cases affecting one or more levels is controversial in the literature, the time between the onset of neurological symptoms and surgical decompression is an important factor affecting surgical outcomes. In this case, we discuss a case of massive thoracic spinal epidural hematoma caused by anticoagulant use, increased intra-abdominal pressure during early mobilization, random compression fracture, and vascular injury due to epidural spinal anesthesi