Journal of Medical and Health Studies
type: channel
description: Journal of Medical and Health Studies (ISSN: 2710-1452) is a peer-reviewed International Journal published by Al-Kindi Center for Research and Development. The journal covers scholarly articles in the fields of Medicine and Public Health. All articles are freely available without charge to the users or their institutions; thus, ensuring high visibility and increasing citations for all research articles published. The journal aims to facilitate scholarly work on recent theoretical and practical aspects of health and medical sciences. Academics, policymakers, and researchers are welcome to submit their manuscripts at any time.
publisher: Al-Kindi Center for Research and Development
language: en
publication name: Journal of Medical and Health Studies
issn: 2710-1452
items: Playing with Colour: A Case Study of Deduako Life Community Special Vocational School and the Garden City Special School
items: The progress of smart healthcare based on Multimodal Data fusion technology
items: Intracerebral Hemorrhage in the Setting of Lamotrigine-Induced Stevens-Johnson Syndrome: A Case Report
items: Artificial Intelligence, ctDNA, and Biomarker-Driven Precision Oncology: Emerging Molecular Strategies for Cancer Diagnosis and Therapeutic Response Prediction
items: Comparative Efficacy of Intravitreal Aflibercept versus Panretinal Photocoagulation for Proliferative Diabetic Retinopathy: A Randomized Controlled Trial
items: Diagnostic Accuracy of Low-Dose CT versus Standard-Dose CT in the Detection of Urolithiasis
items: Assessing the Knowledge and Intention on HIV Prevention Among Senior High School Students in Selected Public Schools of San Pablo City
items: Factors Influencing Mortality in Intracerebral Hemorrhage Patients: A Literature Review
items: Management of the “Ring Finger” or Alliance Finger: Three Cases and a Literature Review
items: Navigating the New Frontier: Enhanced Recovery After Surgery (ERAS) Protocols in Gynecological Nursing Care
items: Body-Contouring Surgery After GLP-1–Induced Massive Weight Loss: Surgical Outcomes, Complications, and Patient-Reported Quality of Life
items: Early versus Delayed Excision and Grafting in Deep Burns: Impact on Healing Time and Hospital Stay
items: Photography in Aesthetic Surgery: Ethical, scientific, and mediatic issues - A Literature Review
items: Converging Wearable Biosensors, Multi-Omics, and Artificial Intelligence: An Integrative Framework for Predictive and Preventive Precision Medicine
items: Optimizing Red Blood Cell Transfusion Thresholds Across Medical, Surgical, and Obstetric Populations: A Systematic Review
items: A Narrative Inquiry on Mothers’ Knowledge and Preventive Practices Regarding Upper Respiratory Tract Infections in Under-Five Children
items: Multi-Scale Attention-Fusion Classification with an LLM-Driven Clinical Recommendation Assistant for Brain Tumor MRI
items: Transcending the Limitations of Total Quality Management through Quality 4.0 in healthcare
items: Incidence and Risk Factors of Third- and Fourth-Degree Perineal Tears in Vaginal Delivery: A Retrospective Study at Bint Al-Huda Teaching Hospital, Nasiriyah, Iraq
items: Duration of Prelabor Rupture of Membranes and Early-Onset Neonatal Sepsis: A Retrospective Cohort with Risk Model
items: Generational Differences in Dimensions of Work Values among Nurses in Community General Hospital
items: A Deadly Mimic: Type A Aortic Dissection Presenting as Inferior STEMI
items: Knowledge and Emergency Response Readiness About Stroke Among At-Risk Individuals
items: Earwax Removal Agents: Review article
items: A Fusion of Machine Learning and Traditional Statistical Forecasting Models for Analyzing American Healthcare Expenditure
items: The Impact of Transformational and Transactional Leadership Styles on Job Satisfaction among Healthcare Workers in Oman: A Systematic Review
items: Human-Centered Artificial Intelligence for Healthcare, Education, Business, and Assistive Technologies
items: Deployable AI Systems for Healthcare, Industry, Business, and Smart Infrastructure: A Cross-Domain Review
items: AI-Enabled Resilient Systems: Healthcare, Sustainability, Cybersecurity, Energy, and Organizational Decision-Making
items: Magnetic Resonance Imaging Patterns of Complex Anal Fistula: A Case Series- MRI of complex anal fistula

Playing with Colour: A Case Study of Deduako Life Community Special Vocational School and the Garden City Special School
type: item
description: Persons with intellectual disabilities (PWID) often experience limitations in cognitive functioning that distinguish them from the broader population. Although these differences may be real or perceived, they frequently result in significant social consequences, including stigma and exclusion. Deeply rooted cultural attitudes tend to reinforce negative perceptions of intellectual disability, often portraying affected individuals as less capable in various aspects of human endeavour. However, emerging perspectives suggest that PWID may demonstrate strengths in non-verbal and visual forms of communication, particularly through artistic expression. This study explored self-expression through art-making among persons with intellectual disabilities using structured creative art sessions. The research adopted a qualitative approach to examine how participants communicate ideas, emotions, and experiences through visual media. The focus was on understanding art as a medium of expression rather than as a measure of technical skill. The study was conducted with students from two special education institutions in Kumasi, Ghana: Deduako Life Community Special Vocational School and Garden City Special School. Participants were engaged in guided colour-based art activities designed to encourage free expression and creativity within a supportive environment. Findings revealed that persons with intellectual disabilities were able to effectively express themselves through visual art. Their works demonstrated originality, emotional engagement, and the ability to convey meaning through colour, form, and composition. The results challenge deficit-based assumptions about intellectual disability and highlight the communicative and expressive potential of PWID. The study concludes that art-making provides an important avenue for self-expression and communication among persons with intellectual disabilities and supports the need for inclusive creative spaces that foster their artistic deve…
subject: Research Article
  topic: section
subject: Art, Art Therapy, Intellectual disability
  topic: keywords
creator: Dorothy Akpene Amenuke
creator: Joshua Nyatefe
creator: Derrick Fiaku
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/
date: 2026-01-28
publication date: 2026-01-28
starting page: 44
ending page: 56
doi: 10.32996/jmhs.2026.7.1.6

The progress of smart healthcare based on Multimodal Data fusion technology
type: item
description: Smart healthcare is moving towards precision, personalization, and intelligence. Multimodal data fusion technology, as a core means to break medical data silos and improve clinical decision-making efficiency, has received extensive attention. This paper systematically reviews the mainstream methods and their performance in typical medical tasks from four levels: data level, feature level, decision level, and hybrid fusion. Based on this, the current commonly used medical multimodal datasets and evaluation criteria are introduced, and the experimental results of various fusion methods on public datasets are summarized. Further, this paper analyzes the challenges of existing methods in terms of data heterogeneity, modal absence, interpretability, and privacy protection, explores the deficiencies in the dataset construction and evaluation system, and proposes corresponding solutions. Finally, it looks forward to future research directions, emphasizing the synergy of medical-engineering integration, privacy computing and explainable models to provide references for the in-depth research and application of multimodal fusion technologies in smart healthcare.
subject: Research Article
  topic: section
subject: Smart healthcare; Multimodal data fusion; Data-level fusion; Feature-level fusion; Decision-level fusion; Hybrid fusion
  topic: keywords
creator: Yining Zhang
creator: Yisu Zhang
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/
date: 2026-07-31
publication date: 2026-07-31
starting page: 92
ending page: 97
doi: 10.32996/jmhs.2026.7.9.12

Intracerebral Hemorrhage in the Setting of Lamotrigine-Induced Stevens-Johnson Syndrome: A Case Report
type: item
description: Stevens-Johnson syndrome is a rare but life-threatening severe cutaneous adverse reaction that may involve multiple organ systems and is commonly associated with medication exposure. Although clinicians are familiar with complications such as sepsis, shock, and multiorgan dysfunction, rare neurological complications may be overlooked. We report the case of a 41-year-old Saudi male with epilepsy who developed Stevens-Johnson syndrome following recent initiation and dose escalation of lamotrigine. The patient presented with fever, generalized malaise, and a rapidly progressive diffuse erythematous maculopapular rash associated with painful oral erosions and systemic symptoms. Examination demonstrated widespread skin involvement with mucosal lesions consistent with Stevens-Johnson syndrome. The patient was admitted for close monitoring due to the severity of the reaction and risk of rapid deterioration. During hospitalization, he developed sudden severe headache, repeated vomiting, fluctuating level of consciousness, and objective unilateral weakness. These findings prompted urgent neurological evaluation, and non-contrast computed tomography of the brain revealed an acute intracerebral hemorrhage with intraventricular extension. The patient was subsequently managed in an intensive care setting with multidisciplinary involvement from dermatology, neurology, neurosurgery, and critical care teams. Supportive management of Stevens-Johnson syndrome was continued alongside neurological monitoring and management of the intracranial hemorrhage. The patient's neurological status gradually improved, with concurrent clinical improvement of the cutaneous manifestations following discontinuation of the suspected medication. This case highlights an uncommon but important complication of Stevens-Johnson syndrome and emphasizes that neurological deterioration should not automatically be attributed to sepsis or systemic inflammation. New focal neurological deficits, severe headache, v…
subject: Research Article
  topic: section
subject: Stevens-Johnson Syndrome, Rash, Oral Mucosa, Fever, Brain Hemorrhage, Sepsis.
  topic: keywords
creator: Areej Ahmed Abdalla Hassan
creator: Waad Ahmed Kamal Ahmed
creator: Amani Trivett
creator: Fajer Ali Albaqer
creator: Talal Ahmed H. Alhawaj
creator: Fajer Duaij AlDoseri
creator: Tahera Jaafar Ahmed
creator: Zainab Ahmed Dhaif
creator: Maher Ali Alqattan
creator: Qasim Jaber Hasan
creator: Safa Sadiq Mohamed
creator: Zainab Yusuf Yaqoob
creator: Fatima Khalid Bughamar
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-07-28
publication date: 2026-07-28
starting page: 82
ending page: 91
doi: 10.32996/jmhs.2026.7.9.11

Artificial Intelligence, ctDNA, and Biomarker-Driven Precision Oncology: Emerging Molecular Strategies for Cancer Diagnosis and Therapeutic Response Prediction
type: item
description: Precision oncology has emerged as a transformative paradigm in cancer diagnosis and therapeutic decision-making through the integration of molecular diagnostics, genomic profiling, artificial intelligence (AI), and translational medicine. Conventional oncology approaches based primarily on histopathological classification frequently fail to address the extensive intertumoral and intratumoral heterogeneity that contributes to therapeutic resistance, metastatic progression, and variable clinical outcomes. Recent advances in next-generation sequencing (NGS), circulating tumor DNA (ctDNA)-based liquid biopsy technologies, transcriptomics, multi-omics integration, and AI-assisted computational oncology have significantly improved biomarker discovery, molecular surveillance, therapeutic response prediction, and personalized treatment strategies. Machine learning and deep learning algorithms are increasingly utilized for tumor classification, digital pathology, radiomics, survival prediction, biomarker-guided therapeutic optimization, and recurrence monitoring. ctDNA-based liquid biopsy platforms further provide minimally invasive approaches for longitudinal tumor profiling, minimal residual disease (MRD) detection, clonal evolution analysis, and real-time therapeutic response monitoring. Molecular biomarkers including EGFR mutations, HER2 amplification, KRAS mutations, microsatellite instability (MSI), tumor mutational burden (TMB), and angiogenic signaling markers are increasingly incorporated into precision therapeutic frameworks. Additionally, AI-assisted integration of genomics, transcriptomics, proteomics, epigenomics, and metabolomics has accelerated translational precision medicine. Despite substantial advances, major challenges remain, including biomarker standardization, AI interpretability limitations, sequencing costs, data heterogeneity, and clinical implementation barriers. This review discusses recent advances in AI-assisted precision oncology, molecular bio…
subject: Research Article
  topic: section
subject: Precision oncology, artificial intelligence, ctDNA, liquid biopsy, molecular biomarkers, translational medicine, computational oncology, therapeutic resistance, personalized medicine
  topic: keywords
creator: Mohammad Mahmudul Hasan Bhuyain
creator: Fariya Chowdhury
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/
date: 2026-07-21
publication date: 2026-07-21
starting page: 71
ending page: 81
doi: 10.32996/jmhs.2026.7.9.10

Comparative Efficacy of Intravitreal Aflibercept versus Panretinal Photocoagulation for Proliferative Diabetic Retinopathy: A Randomized Controlled Trial
type: item
description: Proliferative diabetic retinopathy (PDR) remains a leading cause of preventable blindness among working-age adults worldwide. Pan retinal photocoagulation (PRP) has long been the standard of care, but intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents have emerged as an alternative that may preserve visual function while inducing regression of neovascularization. To compare the efficacy and safety of intravitreal aflibercept versus PRP in eyes with high-risk PDR over 52 weeks. In this trial conducted in Thi-Qar, Iraq, adults with treatment-naïve high-risk PDR were randomized 1:1 to intravitreal aflibercept (2.0 mg every 4 weeks for the first 3 doses, then per protocol) or standard PRP delivered over 1–3 sessions. The primary outcome was mean change in best-corrected visual acuity (BCVA) at week 52; secondary outcomes included central macular thickness (CMT), diabetic retinopathy severity score (DRSS) regression, and adverse events. The aflibercept group demonstrated a greater mean BCVA gain and a higher proportion of eyes achieving ≥ 2-step DRSS regression compared with the PRP group, with a lower rate of vitreous hemorrhage. Both interventions were generally well tolerated.Intravitreal aflibercept demonstrated visual and anatomic advantages for PDR, while PRP remains a durable, low-cost option, particularly where follow-up adherence cannot be guaranteed.
subject: Research Article
  topic: section
subject: Proliferative diabetic retinopathy; anti-VEGF; aflibercept; panretinal photocoagulation; randomized controlled trial
  topic: keywords
creator: Zainab Kadhum Fahad
creator: Mohammed Ali Taher
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by-nc/4.0
date: 2026-07-20
publication date: 2026-07-20
starting page: 65
ending page: 70
doi: 10.32996/jmhs.2026.7.9.9

Diagnostic Accuracy of Low-Dose CT versus Standard-Dose CT in the Detection of Urolithiasis
type: item
description: Non-contrast CT is the reference imaging test for urolithiasis, but the associated radiation dose is a concern, especially in young patients who may undergo repeated scans. This study assessed the diagnostic accuracy of low-dose CT (LDCT) against standard-dose CT (SDCT) for the detection of urinary tract stones. In this prospective comparative study at Al-Hussein Teaching Hospital in Al-Nasiriyah (Thi-Qar Province, Iraq), 150 adults with suspected renal colic underwent both LDCT and SDCT in the same session. SDCT served as the reference standard. Two radiologists, blinded to the reference reading, independently interpreted the LDCT images. Per-patient and per-stone sensitivity, specificity, predictive values, and accuracy were calculated with 95% confidence intervals (CI), with subgroup analysis by stone size and body mass index (BMI) and comparison of effective radiation dose. Reporting followed the STARD 2015 guideline. Urolithiasis was present in 102 of 150 patients (68%). LDCT achieved a per-patient sensitivity of 95.1% (95% CI 88.9–98.4), specificity of 97.9% (95% CI 89.1–99.9), and accuracy of 96.0%. Per-stone sensitivity was 94.0% overall but fell sharply for stones smaller than 3 mm (69.2% vs 98.6% for ≥ 3 mm; p < 0.001) and was lower in patients with BMI ≥ 30 (88.9% vs 97.2%). Inter-observer agreement was excellent (κ = 0.88). The mean effective dose was 76% lower with LDCT (1.9 ± 0.5 vs 8.1 ± 1.8 mSv; p < 0.001). LDCT detected urolithiasis with high accuracy at roughly one-quarter of the radiation dose of SDCT and can serve as the first-line protocol for suspected renal colic. Its main limitation is reduced sensitivity for sub-3-mm stones and in obese patients, where a standard-dose protocol should be considered.
subject: Research Article
  topic: section
subject: Computed tomography; low-dose CT; urolithiasis; renal colic; diagnostic accuracy; radiation dose.
  topic: keywords
creator: Sarah Ghaleb Shati
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/
date: 2026-07-17
publication date: 2026-07-17
starting page: 59
ending page: 64
doi: 10.32996/jmhs.2026.7.9.8

Assessing the Knowledge and Intention on HIV Prevention Among Senior High School Students in Selected Public Schools of San Pablo City
type: item
description: The human immunodeficiency virus (HIV) continues to pose a major public health concern, especially for adolescents and young adults, and there are a growing number of cases being reported worldwide, including in the Philippines. In addition, gaps exist between HIV knowledge and the intention to participate in HIV-preventive behavior despite ongoing prevention initiatives. The purpose of the study was to compare the relationship between HIV knowledge and intention to perform and support HIV preventive actions among selected senior high school students in the public high schools in San Pablo City, Laguna, Philippines. A quantitative, cross-sectional, descriptive correlational design was utilized with 367 respondents who had been randomly selected using a multi-stage sampling process. Using an adapted structured questionnaire, HIV transmission, prevention, and medical management and health services were measured, along with intention to participate in HIV preventive behaviors. Data were analyzed using descriptive statistics and Spearman's rho. A moderate amount of HIV knowledge was reported and a high level of intention to participate in preventive behaviors was also reported. There is a statistically significant but weak positive correlation between the two variables (ρ = 0.124, p = 0.018). There was a major connection between having knowledge about transmission and prevention but there was not a major relationship found between knowledge of medical management or health services. This suggests that there is not much effect of knowledge by itself on an individual's intention to seek the service and therefore shows that a comprehensive behavior-focused education program about health is necessary.
subject: Research Article
  topic: section
subject: Human Immunodeficiency Virus, HIV knowledge; HIV prevention; intention; adolescents; community health nursing
  topic: keywords
creator: Rindsay Lee D. Dichoso
creator: Keith William M. Alamara
creator: Jan Razhiela T. Bulaklak
creator: Rhod Michael V. Roxas
creator: Girlie Mannphy A. Lacambra
creator: Marc Lester F. Quintana
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0
date: 2026-07-14
publication date: 2026-07-14
starting page: 46
ending page: 58
doi: 10.32996/jmhs.2026.7.9.7

Factors Influencing Mortality in Intracerebral Hemorrhage Patients: A Literature Review
type: item
description: Intracerebral hemorrhage (ICH) is a life-threatening neurological condition associated with high mortality rates worldwide. This study aimed to review and synthesize current evidence regarding factors influencing mortality in patients with ICH and to evaluate their relevance to clinical practice at Universitas Airlangga Hospital. A literature review was conducted using 20 peer-reviewed articles published between 2020 and 2025, complemented by three major neurology textbooks. The analysis focused on clinical, radiological, and comorbidity-related predictors of mortality reported in the literature. The findings consistently identified decreased Glasgow Coma Scale (GCS) scores, larger hematoma volumes, intraventricular hemorrhage (IVH), and comorbid conditions such as hypertension and diabetes mellitus as major predictors of mortality. Mortality outcomes were found to be strongly influenced by the interaction between acute hemorrhagic characteristics and underlying systemic diseases. Furthermore, the presence of IVH, infratentorial hemorrhage, hypertension, and diabetes mellitus emerged as key prognostic factors associated with poor clinical outcomes. These findings suggest that early risk stratification based on neuroimaging features, alongside comprehensive management of comorbidities during the acute phase, is essential for guiding clinical decision-making and improving patient outcomes in tertiary healthcare settings, including Universitas Airlangga Hospital.
subject: Research Article
  topic: section
subject: Intracerebral Hemorrhage, In-hospital Mortality, Prognostic Factors, Intraventricular Hemorrhage, Comorbidities
  topic: keywords
creator: Andrew Yuda Lamba
creator: Abdullah Machin
creator: Asra Al Fauzi
creator: Lathifatul Fikriyah
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/
date: 2026-07-03
publication date: 2026-07-03
starting page: 06
ending page: 08
doi: 10.32996/jmhs.2026.7.9.2

Management of the “Ring Finger” or Alliance Finger: Three Cases and a Literature Review
type: item
description: Ring finger is a serious accident characterized by a vascular and neurovascular avulsion and skin detachment. This serious accident follows sudden traction exerted on a finger by a ring, well known to hand surgeons.but much less known to other health professionals and even less to the general public. The authors report the observations of three patients, two of whom benefited from McGregor inguinal flap coverage after surgical debridement and amputation for the third with satisfactory functional and aesthetic results, and also address, after reviewing the literature, the different aspects of this pathology.
subject: Research Article
  topic: section
subject: Alliance finger, Hand trauma, Inguinal flap, Amputation
  topic: keywords
creator: FALL N.Y
creator: BADAOUI Z
creator: ACHBOUK A
creator: RIBAG Y
creator: EL KHATIB K
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by-nc/4.0
date: 2026-07-03
publication date: 2026-07-03
starting page: 01
ending page: 05
doi: 10.32996/jmhs.2026.7.9.1

Navigating the New Frontier: Enhanced Recovery After Surgery (ERAS) Protocols in Gynecological Nursing Care
type: item
description: Gynecological surgery procedures are responsible for millions of hospital admissions worldwide annually; however, the perioperative recovery protocols have always been based on conservative strategies, which are often paternalistic, based on the convenience of the surgeon and not the patient. Enhanced Recovery After Surgery (ERAS) protocols signify a paradigm shift, a coordinated, multimodal approach to surgery that undermines traditional practices of lengthy fasting, routine use of opioids, and delayed mobilization. Despite strong evidence of surgical impact, the crucial role of nursing in ERAS implementation has not been fully explored in the scholarly literature. This integrative review explores the current understanding of ERAS programs in gynecological surgical practice, focusing specifically on the nursing profession in the preoperative, operative, and postoperative phases. This paper also outlines the institutional challenges to the uptake of ERAS and suggests evidence-based strategies for its sustainable implementation. A systematic search of the PubMed, CINAHL, Cochrane Library, Embase, and MEDLINE databases was performed for literature published from 2017 to 2026. The Boolean search strategies included "ERAS," "enhanced recovery," "gynecological surgery," "perioperative nursing," "hysterectomy," and " The Critical Appraisal Skills Program (CASP) was used to critically appraise 47 studies that met the inclusion criteria. ERAS protocols have been shown to repeatedly shorten hospital stays by 1-2 days, reduce postoperative opioid use by 30-60 percent, improve complication rates, and enhance patient-reported outcomes of quality recovery. The implementation of the nurse’s role as a vital coordinator throughout the surgical continuum is often limited by a lack of knowledge, institutional resistance, and poor interprofessional collaboration. The adoption of ERAS becomes more standardized when it is integrated into gynecological nursing practice, which involves th…
subject: Research Article
  topic: section
subject: enhanced recovery after surgery, ERAS, gynecological nursing, perioperative care, hysterectomy, opioid stewardship, patient-centered care, nursing role, evidence-based practice
  topic: keywords
creator: Jaima Karim
creator: Jawad Karim
creator: Moshammat Zebunnesa
creator: Mohammad Masud Karim
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-07-05
publication date: 2026-07-05
starting page: 27
ending page: 41
doi: 10.32996/jmhs.2026.7.9.5

Body-Contouring Surgery After GLP-1–Induced Massive Weight Loss: Surgical Outcomes, Complications, and Patient-Reported Quality of Life
type: item
description: The rapid adoption of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has created a growing population presenting for body-contouring surgery after pharmacologically induced massive weight loss (MWL). Whether outcomes differ from those after bariatric-induced MWL is uncertain. This study compared surgical outcomes, 90-day complications, and patient-reported quality of life between the two groups. In this prospective comparative cohort, 90 adults undergoing body contouring after MWL were grouped by weight-loss modality: GLP-1 RA pharmacotherapy (n = 45) or bariatric surgery (n = 45). Procedures included abdominoplasty/panniculectomy with or without brachioplasty, thighplasty, or mastopexy. The primary outcome was the incidence of complications within 90 days; the secondary outcome was change in the BODY-Q (Satisfaction with Body, Psychological and Physical Function) from baseline to 6 months. Predictors of complications were examined by multivariable logistic regression. The groups were similar in age and sex; the bariatric group had a higher peak body mass index (BMI) and greater total weight loss. The overall 90-day complication rate did not differ between GLP-1 and bariatric groups (19.0% vs 22.2%; p = 0.69), nor did any individual complication. BODY-Q scores improved markedly in both groups (Satisfaction with Body +33.3 vs +36.3 points; both p < 0.001), with no significant between-group difference. On multivariable analysis, BMI at surgery (adjusted OR 1.78 per 5 kg/m²; p = 0.02) and current smoking (OR 2.40; p = 0.04) predicted complications, whereas weight-loss modality did not (OR 0.83; p = 0.69). Body contouring after GLP-1–induced MWL produced complication rates and quality-of-life gains comparable to those after bariatric-induced MWL. Residual obesity and smoking, rather than the method of weight loss, drove complication risk. These findings support offering body contouring to GLP-1 patients with attention to perioperative optimisation.
subject: Research Article
  topic: section
subject: GLP-1 receptor agonists; massive weight loss; body contouring; abdominoplasty; complications; BODY-Q; patient-reported outcomes
  topic: keywords
creator: Rabab Abbas Hasan
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/
date: 2026-06-28
publication date: 2026-06-28
starting page: 152
ending page: 157
doi: 10.32996/jmhs.2026.7.8.10

Early versus Delayed Excision and Grafting in Deep Burns: Impact on Healing Time and Hospital Stay
type: item
description: Excision and grafting is the standard surgical treatment of deep burns, but the optimal timing remains debated. This study compared early versus delayed excision and grafting (E&G) with respect to wound healing time and length of hospital stay. In this prospective comparative cohort, 80 adults with deep partial- and full-thickness burns of 10–30% total body surface area (TBSA) were managed by early E&G (excision within 5 days of injury; n = 40) or delayed E&G (excision after eschar separation, beyond 14 days; n = 40). The primary outcomes were time to complete wound healing and length of hospital stay. Secondary outcomes were graft take, wound infection, number of operations, blood-transfusion requirement, and mortality. Groups were compared with independent-samples t-tests and chi-square tests, and length of stay was modelled by multivariable linear regression. The two groups were comparable at baseline (mean age 35.5 years; mean TBSA 18.4%). Early E&G was associated with shorter time to complete healing (24.3 ± 6.1 vs 38.7 ± 8.9 days; mean difference 14.4 days; 95% CI 11.0–17.8; p < 0.001) and shorter hospital stay (19.8 ± 5.7 vs 31.4 ± 8.2 days; mean difference 11.6 days; 95% CI 8.5–14.7; p < 0.001). Graft take was higher (92.4% vs 88.1%; p = 0.03) and wound infection lower (17.5% vs 37.5%; p = 0.045) in the early group. Early E&G required more blood transfusion (3.1 ± 1.4 vs 1.9 ± 1.1 units; p < 0.001). Mortality did not differ (5.0% vs 7.5%; p = 0.64). Early excision and grafting of deep burns shortened healing time and hospital stay and reduced wound infection, at the cost of greater intraoperative blood transfusion. These findings support early surgery for suitable patients with deep burns, with attention to perioperative blood management.
subject: Research Article
  topic: section
subject: deep burns; early excision; skin grafting; wound healing; length of stay; surgical timing
  topic: keywords
creator: Rabab Abbas Hasan
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0
date: 2026-05-28
publication date: 2026-05-28
starting page: 129
ending page: 134
doi: 10.32996/jmhs.2027.7.7.15

Photography in Aesthetic Surgery: Ethical, scientific, and mediatic issues - A Literature Review
type: item
description: Photography has become a cornerstone of aesthetic surgery practice. An essential tool for clinical documentation, it has also evolved, in the digital era, into a vector for medical communication, professional education, and, at times, commercial promotion. This literature review critically and comprehensively analyses the multiple dimensions of medical photography in aesthetic surgery: historical background, legal and ethical framework, scientific applications, mediatic implications, and technical standards of good practice. It draws on data from the international literature, enriched by the specificities of the Moroccan context. The findings highlight the imperative for a rigorous, standardised, and ethically irreproachable photographic practice, grounded in informed patient consent, protection of personal health data, and respect for human dignity. When properly applied, photography is a major clinical and scientific asset for the practitioner; when poorly managed, it exposes both physician and patient to significant medico-legal and ethical risks.
subject: Research Article
  topic: section
subject: Medical photography, aesthetic surgery, medical ethics, legal framework, social media, photographic standardisation, informed consent, health data
  topic: keywords
creator: AMINE KHALES
creator: ASMAA MOUJAHID
creator: Mohamed Benani
creator: ZAKARIA BADAOUI
creator: AISSAM MOKFI
creator: AMINE ALAOUI
creator: YASMINA RIBAG
creator: CHAKIB CHOUIKH
creator: ABDELHAFID ACHBOUK
creator: MOHAMED KARIM EL KHATIB
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-07-03
publication date: 2026-07-03
starting page: 158
ending page: 167
doi: 10.32996/jmhs.2026.7.8.11

Converging Wearable Biosensors, Multi-Omics, and Artificial Intelligence: An Integrative Framework for Predictive and Preventive Precision Medicine
type: item
description: Precision medicine aspires to tailor prevention, diagnosis, and treatment to the individual rather than to a statistical average, yet that ambition has long outrun the data and the tools needed to deliver it. Three streams of biomedical information now make the goal tangible, even if they have matured along largely separate paths: high-dimensional molecular profiles drawn from multi-omics platforms, continuously recorded physiological signals from wearable biosensors, and the messy, accumulating record of routine clinical care. Artificial intelligence, and machine learning in particular, has become the connective tissue that can bind these unlike sources into models a clinician might actually use. This article advances an integrative framework in which multi-omics data establish a patient's molecular baseline, wearable sensors trace the longitudinal phenotype as it shifts from day to day, and learning algorithms translate the combined signal into predictions that are both clinically meaningful and individually calibrated. We review the methodological terrain of data integration, trace applications across oncology, cardiovascular medicine, chronic disease prevention, and drug discovery, and weigh the obstacles, spanning data heterogeneity, model opacity, validation, equity, and privacy, that still separate promising prototypes from everyday practice. Our central argument is that the most durable near-term gains will not come from any single modality in isolation but from disciplined, transparent fusion of all three, anchored by rigorous external validation and a steady concern for fairness.
subject: Research Article
  topic: section
subject: Precision Medicine; Multi-Omics; Machine Learning; Deep Learning; Wearable Biosensors; Data Integration; Predictive Analytics
  topic: keywords
creator: Kaniz Sultana Chy
rights: Copyright (c) 2022 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0
date: 2022-12-30
publication date: 2022-12-30
starting page: 201
ending page: 212
doi: 10.32996/jmhs.2022.3.4.29

Optimizing Red Blood Cell Transfusion Thresholds Across Medical, Surgical, and Obstetric Populations: A Systematic Review
type: item
description: Red blood cell (RBC) transfusion remains a cornerstone of supportive care across medical, surgical, and obstetric settings; however, the optimal hemoglobin threshold for transfusion continues to be debated due to concerns regarding transfusion-related complications, resource utilization, and patient outcomes. This systematic review aimed to evaluate the efficacy and safety of restrictive versus liberal RBC transfusion strategies across diverse adult patient populations. A comprehensive literature search of PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, and ClinicalTrials.gov was conducted from database inception through June 2026 in accordance with PRISMA 2020 guidelines. Studies comparing restrictive transfusion thresholds (typically 7–8 g/dL) with liberal thresholds (typically 9–10 g/dL) were included. A total of 97 studies involving more than 350,000 patients were analyzed. Across critically ill patients, septic shock, gastrointestinal bleeding, orthopedic surgery, and cardiac surgery populations, restrictive transfusion strategies consistently reduced blood product utilization without increasing mortality, cardiovascular complications, infection rates, length of hospital stay, or other major adverse outcomes. In patients with acute gastrointestinal bleeding, restrictive transfusion was associated with improved survival and lower rebleeding rates. Evidence from obstetric populations suggested similar maternal outcomes with reduced transfusion exposure, although data were less robust than those available for medical and surgical cohorts. Uncertainty persists in selected high-risk populations, including patients with acute coronary syndromes, severe cardiovascular disease, and major obstetric hemorrhage, where individualized clinical assessment remains essential. Overall, current evidence strongly supports restrictive RBC transfusion strategies as a safe, effective, and resource-efficient approach for most hemodynamically stable adult patients, r…
subject: Research Article
  topic: section
subject: Red blood cell transfusion; Restrictive transfusion; Liberal transfusion; Hemoglobin threshold; Patient blood management; Critical care; Surgery; Obstetrics; Anemia; Systematic review.
  topic: keywords
creator: Alya Jameel Ahmed Hasan
creator: Zainab Aljammali
creator: Sara Ahmed Saleh
creator: Abeer Abdulmoamen Alomari
creator: Zainab Jameel Khamis
creator: Hanin Sami Ibrahim Ali
creator: Abdul Fattah Salem
creator: Fatema Mustafa Marhoon
creator: Sayed Hasan Neama Alhashimi
creator: Mohamed Kareem Alshehab
creator: Ali Hamza Mohamed
creator: Mariam Husain Alhajee
creator: Sara Mohammed Majeed
creator: Naeema Radhi Rabeea
creator: Basant Sami I. Ali
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-06-25
publication date: 2026-06-25
starting page: 128
ending page: 151
doi: 10.32996/jmhs.2026.7.8.9

A Narrative Inquiry on Mothers’ Knowledge and Preventive Practices Regarding Upper Respiratory Tract Infections in Under-Five Children
type: item
description: Upper Respiratory Tract Infections (URTIs) remain a primary health challenge for pediatric populations, particularly in high-density communities. This study explored the lived experiences, knowledge, and preventive practices of mothers managing URTIs in children under five years old in Barangay San Nicolas, San Pablo City. Utilizing a narrative inquiry research design, semi-structured interviews were conducted with 15 purposely selected mothers to uncover the meanings behind their caregiving decisions. The narratives were examined to identify recurring experiences, patterns, and meanings related to mothers’ knowledge, practices, and decision-making in managing URTIs. Trustworthiness was enhanced through participant validation and careful documentation of the research process. The results identified a “layered response” to illness, wherein mothers initially employed traditional home remedies, such as oregano and calamansi, based on experiential knowledge before seeking professional medical consultation. While mothers demonstrated awareness of environmental triggers such as dust and smoke, structural barriers, including financial instability and inconsistent medicine supplies at local health centers, often hindered optimal care. The study concludes that maternal decision-making is a dynamic process shaped by a blend of traditional wisdom, socio-economic realities, and interactions with healthcare providers. By capturing mothers’ personal narratives, this study contributes a contextualized understanding of childhood URTI management within a community setting. Integrating nursing, public health, and socio-economic perspectives, the findings suggest that community health interventions should strengthen partnerships between health workers and mothers, improve access to essential healthcare resources, and support timely recognition and management of pediatric URTIs.
subject: Research Article
  topic: section
subject: Child health
  topic: keywords
subject: Health-seeking behaviors
  topic: keywords
subject: Maternal knowledge
  topic: keywords
subject: Narrative Inquiry
  topic: keywords
subject: Upper respiratory tract infections
  topic: keywords
creator: Cleo Alexene Estrada
creator: Kristelle Anne Atienza
creator: Venice Carro
creator: Althea May Libang
creator: Kathleen Corcolon
creator: Marc Lester Quintana
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-07-03
publication date: 2026-07-03
starting page: 21
ending page: 26
doi: 10.32996/jmhs.2026.7.9.4

Multi-Scale Attention-Fusion Classification with an LLM-Driven Clinical Recommendation Assistant for Brain Tumor MRI
type: item
description: Brain tumor MRI interpretation remains constrained by radiologist shortages, inter-reader variability, delayed specialist access, and high diagnostic cost, particularly in low-resource settings. Although deep learning classifiers can assign tumor labels, a class prediction alone does not provide actionable guidance on urgency, referral, follow-up, or patient-facing interpretation. This study proposed a combined diagnostic and recommendation framework comprising an MSAF-Net classifier and a confidence-conditioned retrieval-augmented GPT-2 clinical assistant. MSAF-Net used a ConvNeXt-T/Swin-T hierarchical stem, per-stage channel-spatial attention, gated cross-scale feature fusion, and a compact classification head for four-class brain tumor MRI classification. The assistant converted the predicted class and confidence score into a structured query, retrieved relevant evidence from a curated brain-tumor knowledge base, and generated a plain-language, evidence-grounded recommendation with a PDF report. On the 7,023-image four-class Kaggle brain tumor MRI dataset, MSAF-Net achieved 99.16% accuracy, 0.9897 macro-F1, and 0.9985 AUC. Cross-dataset evaluation showed 99.46% accuracy on Figshare CE-MRI and 99.74% accuracy on BR35H. The model remained computationally efficient, with 22.9M parameters, 3.54 GFLOPs, 10 ms inference per scan, and an expected calibration error of 0.0179. These findings indicate that the proposed framework can support accurate classification while translating predictions into clinically usable next-step recommendations. The system is intended to assist, not replace, clinicians by improving decision support, reducing per-case cost, and widening access to neuroimaging guidance.
subject: Research Article
  topic: section
subject: Brain tumor MRI; MSAF-Net; attention fusion; GPT-2; retrieval-augmented generation; clinical decision support
  topic: keywords
creator: Kallol Chakraborty Shekhor
creator: Md Sahid Hossain
creator: Md Abedur Rahman
creator: Md Anwar Hossain
rights: Copyright (c) 2023 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/
date: 2023-03-11
publication date: 2023-03-11
starting page: 121
ending page: 139
doi: 10.32996/jmhs.2023.4.2.15

Transcending the Limitations of Total Quality Management through Quality 4.0 in healthcare
type: item
description: Total Quality Management (TQM) has been the foundational framework for quality improvement in healthcare, emphasizing continuous process improvement, patient-centered care, and organizational commitment to excellence. The growing complexity of modern healthcare driven by digitalization, data explosion has imposed challenges on TQM. This paper examines how Quality 4.0, an evolution of traditional quality management paradigms augmented by digital technologies, offers a transformative pathway for healthcare organizations seeking to transcend these limitations. Critical structural limitations such as manual procedures, siloed data, human-dependent quality audits hindering dynamic patient safety challenges have been discussed. The relevance of Quality 4.0 in enhancing diagnostic accuracy and reducing adverse events, optimizing operational workflows are presented. AI-driven quality prediction, automated compliance monitoring, and data-driven root cause analysis offer capabilities far beyond the scope of conventional TQM tools, enabling healthcare systems to achieve measurable, scalable, and sustainable quality outcomes. The transformative potentials and challenges associated with transition have also been discussed. In conclusion, Quality 4.0 does not render TQM obsolete; rather, it provides the digital architecture needed to extend and amplify TQM's foundational principles in a modern healthcare context.
subject: Research Article
  topic: section
subject: Total Quality Management, Quality 4.0, Healthcare Quality, Digital Transformation, Quality Improvement, Data silos
  topic: keywords
creator: Ayeda Mattar Al Hosani
creator: Premanandh Jagadeesan
creator: Kamarul Bahari Bin Yaakub
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-07-09
publication date: 2026-07-09
starting page: 42
ending page: 45
doi: 10.32996/jmhs.2026.7.9.6

Incidence and Risk Factors of Third- and Fourth-Degree Perineal Tears in Vaginal Delivery: A Retrospective Study at Bint Al-Huda Teaching Hospital, Nasiriyah, Iraq
type: item
description: Obstetric anal sphincter injuries (OASIS) — third- and fourth-degree perineal tears — are an important cause of maternal morbidity, including anal incontinence, perineal pain, dyspareunia, and psychological distress. Their reported incidence varies widely (0.6–19.3%) with detection practices and case-mix. This study determined the incidence of third- and fourth-degree tears among vaginal deliveries and identified independent risk factors at a tertiary maternity hospital in southern Iraq. A retrospective hospital-based study (cross-sectional for incidence with a nested case–control component for risk factors) was conducted at Bint Al-Huda Teaching Hospital, Nasiriyah, over the period 2023–2025. All vaginal deliveries were classified for perineal trauma using the RCOG/Sultan classification. Cases (OASIS) were compared with controls (vaginal delivery without OASIS). Maternal, intrapartum, and fetal variables were analysed by univariate testing followed by multivariable logistic regression, reporting adjusted odds ratios (aOR) with 95% confidence intervals; p<0.05 was significant. Reporting followed STROBE. Among 3,000 vaginal deliveries, OASIS occurred in 150 (5.0%) — 126 (4.2%) third-degree and 24 (0.8%) fourth-degree. On multivariable analysis, the independent risk factors were forceps delivery (aOR 6.20), nulliparity (aOR 5.80), occipito-posterior position (aOR 2.44), birthweight >4 kg (aOR 2.30), prolonged second stage (aOR 2.00), shoulder dystocia (aOR 1.90), and oxytocin augmentation (aOR 1.70); epidural analgesia was not independently associated. OASIS rates rose steeply with operative delivery (3.0% spontaneous, 9.5% vacuum, 16.0% forceps). OASIS at this centre was driven mainly by operative vaginal delivery, nulliparity, and fetal macrosomia. Selective mediolateral episiotomy (at ~60°) in instrumental delivery, structured manual perineal protection, and routine post-delivery rectal examination are recommended to reduce incidence and improve detection.
subject: Research Article
  topic: section
subject: Perineal tear; obstetric anal sphincter injury; OASIS; vaginal delivery; risk factors; episiotomy; Iraq
  topic: keywords
creator: Huda Adnan Sahib
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by-nc/4.0
date: 2026-06-18
publication date: 2026-06-18
starting page: 110
ending page: 116
doi: 10.32996/jmhs.2026.7.8.7

Duration of Prelabor Rupture of Membranes and Early-Onset Neonatal Sepsis: A Retrospective Cohort with Risk Model
type: item
description: Prelabor rupture of membranes (PROM) is an established risk factor for early-onset neonatal sepsis (EONS), but the quantitative relationship between rupture-to-delivery latency and EONS in resource-constrained settings without universal group B streptococcus (GBS) screening is incompletely characterized, and contemporary data from southern Iraq are absent from the indexed literature. To estimate the incidence of EONS among infants born after PROM at a single tertiary center, to quantify the association between ROM-to-delivery latency and EONS, and to develop and internally validate a multivariable risk model usable at the point of care. A retrospective single-center cohort study was conducted at Nasiriyah Teaching Hospital from January 2020 through December 2024. Singleton live births at 34 weeks of gestation or more with documented PROM and complete ROM-timing data were included. The primary outcome was EONS within 72 hours of birth, defined as culture-proven sepsis or clinical sepsis with supportive laboratory and clinical course. The primary exposure was ROM-to-delivery latency, analyzed both categorically (< 12, 12–18, > 18 hours) and per 6-hour increment. Multivariable logistic regression identified independent predictors; discrimination was assessed by the area under the receiver operating characteristic curve (AUC) with 1,000-resample bootstrap internal validation, and reporting followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) statements. Of 1,486 PROM births screened, 968 formed the analytic cohort; EONS occurred in 138 (14.3%, 95% confidence interval [CI] 12.1–16.7%), of which 37 (26.8%) were culture-proven, predominantly Klebsiella species and GBS. ROM-to-delivery latency greater than 18 hours was independently associated with EONS (adjusted odds ratio [aOR] 3.42, 95% CI 2.11–5.54), with risk rising approxim…
subject: Research Article
  topic: section
subject: Prelabor rupture of membranes; early-onset neonatal sepsis; latency; chorioamnionitis; risk model; predictors; neonatal infection
  topic: keywords
creator: Huda Adnan Sahib
creator: Roua Hameed Kadhem
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/
date: 2026-05-20
publication date: 2026-05-20
starting page: 120
ending page: 128
doi: 10.32996/jmhs.2027.7.7.14

Generational Differences in Dimensions of Work Values among Nurses in Community General Hospital
type: item
description: Generational differences in nurses’ work values introduce complexity in forming a unified nursing practice in a multi-generational healthcare setting. This study focused on the distinct work values—intrinsic, extrinsic, social, and prestige values of Generations X, Y and Z at Community General Hospital, filling the gap in understanding of how these values manifest across diverse cultural and organizational contexts of San Pablo City, Laguna. This study used an explanatory sequential mixed-method approach. The initial quantitative phase involved 101 registered nurses, representing 21 from Generation X, 40 from Generation Y, and 40 from Generation Z. Afterward, 12 purposively selected registered nurses were gathered for the qualitative phase. Quantitative data from an adapted Work Values Scale was statistically evaluated through weighted means and Kruskal-Wallis tests. This assessment revealed that while a core commitment to clinical competence, meaningful work, and patient care was steady across the entire nursing staff, individual generational cohorts possessed entirely different secondary motivations. Nurses from Generation Z were motivated primarily by the social and intrinsic values, with a strong emphasis on achieving career advancement and receiving peer mentoring. Nurses from Generation Y were motivated primarily by the financial stability that would come from their salary and benefits. Finally, Generation X emphasized workplace prestige, professional respect, and peer mentorship. Qualitative results corroborated these differences indicating that although nurses’ establish similar ethical standards, they interpret recognition and organizational support differently based on their career stage. The results of this study concluded that the hospital institution must rely on specialized values training and targeted team-dynamics initiatives to promote and build stronger collaboration and lower turnover rates. By addressing these generational differences, this resea…
subject: Research Article
  topic: section
subject: generational differences, nurses, work values, philippines, mixed-method
  topic: keywords
creator: Aile Elijah G. Sanchez
creator: Sazelle Mia C. Caday
creator: Hanna Mitzi Melo
creator: Angel Bea Offemaria
creator: Mikel Anne C. Tailan
creator: Kathleen B. Corcolon
creator: Marc Lester F. Quintana
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/
date: 2026-06-14
publication date: 2026-06-14
starting page: 76
ending page: 99
doi: 10.32996/jmhs.2026.7.8.5

A Deadly Mimic: Type A Aortic Dissection Presenting as Inferior STEMI
type: item
description: Acute Type A aortic dissection is a life threatening cardiovascular emergency that may present with clinical and electrocardiographic findings resembling acute myocardial infarction, creating a significant diagnostic challenge. We report the case of a 58 year old male with a history of hypertension who presented to the emergency department with sudden onset severe central chest pain radiating to the back, associated with diaphoresis, nausea, and vomiting. On arrival, he was tachycardic and relatively hypotensive but remained alert and neurologically intact. Initial electrocardiography demonstrated hyperacute T waves in the inferior leads with reciprocal ST segment depression in the anterior leads, representing an inferior STEMI equivalent pattern. High sensitivity troponin was elevated, further supporting an initial diagnosis of acute coronary syndrome. Despite treatment and preparation for urgent coronary angiography, persistent chest pain radiating to the interscapular region, mild mediastinal widening on chest radiography, and relative hypotension prompted further evaluation. Bedside transthoracic echocardiography demonstrated a mildly dilated ascending aorta, a small pericardial effusion, and findings suspicious for an intimal flap. Subsequent computed tomography angiography confirmed an extensive Stanford Type A aortic dissection involving the ascending aorta and aortic root with extension to the origin of the right coronary artery, resulting in coronary malperfusion. The patient underwent prompt medical stabilization with intravenous beta blockade and analgesia before transfer to a tertiary cardiothoracic center, where successful emergency surgical repair was performed. His postoperative recovery was uncomplicated, and he was discharged home in stable condition. This case highlights the importance of maintaining a broad differential diagnosis in patients presenting with apparent STEMI, particularly when atypical features such as abrupt pain onset, radiation to…
subject: Research Article
  topic: section
subject: Myocardial infarction, ST elevation, Aortic dissection, Chest Pain.
  topic: keywords
creator: Yaqoob Yusuf Ali
creator: Ghadeer Mohamed Naser
creator: Walaa Sadeq Ali
creator: Fatima Fadhel Moosa
creator: Kawthar Maki Albahrani
creator: Sayed Mohamed Hameed Alawi
creator: Hadi Abdulnabi Aqroof
creator: Zahra Mohamed Almarzooq
creator: Walaa Ebrahim Khamis
creator: Noor Saeed Khamis
creator: Zainab Abdulzahra Salman
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-06-14
publication date: 2026-06-14
starting page: 100
ending page: 109
doi: 10.32996/jmhs.2026.7.8.6

Knowledge and Emergency Response Readiness About Stroke Among At-Risk Individuals
type: item
description: Stroke remains a leading cause of mortality and disability worldwide, particularly among individuals with chronic conditions such as hypertension and diabetes. Despite existing awareness efforts, a gap persists between stroke knowledge and actual emergency response behavior, contributing to poor health outcomes. This study aimed to determine the relationship between stroke knowledge and emergency response readiness among at-risk individuals in selected barangays of San Pablo City. A descriptive-correlational cross-sectional design was employed involving 400 respondents diagnosed with hypertension and/or diabetes. Data were collected using an adapted Stroke Knowledge Test and Stroke Action Test. Descriptive and inferential statistics were utilized to assess levels of knowledge, readiness, and their relationship. Results revealed that 55.75% of respondents had moderate stroke knowledge, while 41.75% demonstrated low emergency response readiness. A very weak but statistically significant positive correlation was found between stroke knowledge and emergency response readiness (ρ = 0.140, p = 0.005). These findings suggest that knowledge alone may not sufficiently influence emergency response behavior among at-risk individuals. The study highlights the need for community-based health education and nursing interventions that not only increase stroke awareness but also strengthen practical response skills during stroke emergencies.
subject: Research Article
  topic: section
subject: stroke prevention
  topic: keywords
subject: emergency response readiness
  topic: keywords
subject: stroke knowledge
  topic: keywords
subject: community health nursing
  topic: keywords
subject: at-risk individuals
  topic: keywords
creator: Alfonsa Reyes
creator: Arth Caesar H. Barbacena
creator: Cassandra Verone V. Diongco
creator: John Louis B. Umali
creator: Vivian P. Lajara
creator: Marc Lester F. Quintana
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-07-03
publication date: 2026-07-03
starting page: 09
ending page: 20
doi: 10.32996/jmhs.2026.7.9.3

Earwax Removal Agents: Review article
type: item
description: Earwax (cerumen) is a natural secretion essential for ear health, but its impaction can lead to symptoms such as hearing loss, pain, and discomfort. This review article examines various earwax removal agents, classified into oil-based (e.g., olive oil, mineral oil, almond oil), water-based (e.g., sodium bicarbonate, saline, docusate sodium), and non-water/non-oil solutions (e.g., carbamide peroxide, glycerol, triethanolamine polypeptide). The review synthesizes findings from clinical studies, including a 2018 Cochrane Library review, which indicated that while active therapies improve complete earwax clearance (22%) compared to no treatment (5%), high-quality evidence supporting ear drops or sprays remains limited. Specific agents such as Cerumol®, Sofenz®, Otex®, and hydrogen peroxide are discussed in terms of their components, mechanisms of action (e.g., wax softening, gas bubble formation, hydration), efficacy, and adverse effects (e.g., irritation, pain). The article also highlights guideline recommendations from the British National Formulary (BNF) and the American Academy of Otolaryngology. It concludes that while many cerumenolytics are available, evidence varies, and patient-specific factors (e.g., eardrum perforation, age, infection) must guide treatment choices. Further well-designed randomized controlled trials are needed to address current evidence gaps.
subject: Research Article
  topic: section
subject: Earwax; Cerumen; Cerumenolytic; Ear drops; Earwax impaction; and Ear cleaning.
  topic: keywords
creator: Ali Aljaberi
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-06-21
publication date: 2026-06-21
starting page: 117
ending page: 127
doi: 10.32996/jmhs.2026.7.8.8

A Fusion of Machine Learning and Traditional Statistical Forecasting Models for Analyzing American Healthcare Expenditure
type: item
description: US healthcare expenditure rose from 5.0% of GDP in 1960 to 18.3% in 2021 far exceeding comparable high-income nations despite persistently inferior health outcomes, most notably lower life expectancy. Although machine learning (ML) algorithms and traditional ARIMA time-series models each carry distinct predictive strengths, the literature lacks rigorous comparative analyses that simultaneously evaluate accuracy, efficiency, and interpretability trade-offs. This study addresses that gap by benchmarking five modeling approaches: (1) Random Forest, (2) Gradient Boosting Machine, (3) Support Vector Regression, (4) ARIMA (0,1,1), and (5) a novel Hybrid Fusion model that integrates Bayesian feature selection with an ML ensemble and ARIMA residual correction, drawing on 62 years (1960–2021) of annual US healthcare expenditure data. National Health Expenditure Accounts (NHEA) data from the Centers for Medicare & Medicaid Services (1960–2021; N=62 annual observations) were used. All five models were evaluated through k-fold cross-validation (k=5) on multiple performance dimensions: RMSE, MAE, MAPE, training time, memory usage, and inference speed. Random Forest achieved lowest RMSE (0.297%) among individual ML algorithms, forecasting 18.81% healthcare spending for 2050 compared to ARIMA(0,1,1) at 17.92% (RMSE 0.456%). Support Vector Regression demonstrated severe overfitting (RMSE 12.75%), confirming its unsuitability for small datasets (N=62). Novel hybrid fusion approach achieved 0.261% RMSE, 12% improvement over Random Forest alone. Linear regression analysis confirmed statistically significant annual healthcare spending growth of 0.239% GDP (t=107.79, p<2.16E-70) across full 62-year period. Ensemble machine learning methods substantially outperform traditional ARIMA for healthcare cost forecasting, particularly in capturing non-linear cost dynamics. Hybrid fusion approaches optimize accuracy-interpretability trade-offs [38]. Practical decision frameworks guide healthcare…
subject: Research Article
  topic: section
subject: Healthcare cost prediction, machine learning, ARIMA forecasting, Random Forest, Support Vector Regression, hybrid ensemble methods, comparative analysis, healthcare expenditure forecasting.
  topic: keywords
creator: Anik Biswas
creator: Abdullah Al Mahmud Ashik
creator: Safiul Islam
rights: Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0
date: 2024-03-30
publication date: 2024-03-30
starting page: 95
ending page: 105
doi: 10.32996/jmhs.2024.5.1.12

The Impact of Transformational and Transactional Leadership Styles on Job Satisfaction among Healthcare Workers in Oman: A Systematic Review
type: item
description: Healthcare leadership is a central factor influencing workforce satisfaction, retention and service quality, particularly in health systems undergoing reform. Effective leadership, workforce stability and culturally responsive management is a value that has been introduced in Oman through healthcare transformation as part of Oman Vision 2040. A systematic review was done to establish the impact of transformational and transactional leadership styles on job satisfaction among Omani healthcare workers. The research used was systematic review that was guided by the PICO framework. The population of interest was Omani healthcare workers, the exposure was transformational and transactional leadership, the comparison was other leadership/management styles, and the outcome was job satisfaction. An evidence base provided went through a PRISMA-informed selection process. Thirty-eight records were identified and screened, 28 full-text reports were assessed for eligibility, and 15 studies were included in the narrative synthesis. The evidence included was categorized into direct Oman healthcare evidence, GCC healthcare evidence, international healthcare evidence and indirect organisational evidence. Quality of the studies was evaluated based on CASP-based principles of appraisal, such as the study design, relevance, sampling, measurement, bias and transferability. Meta-analysis was not done because the studies vary greatly in terms of design, population, outcome measures and statistical reporting. The findings indicated that transformational leadership was more effective in predicting positive job satisfaction particularly through motivation, communication, recognition, professional development, trust and organisational commitment. The correlation between transactional leadership and job satisfaction was conditional; it can help to increase satisfaction when applied to increase clarity of roles, accountability and fair feedback, but can decrease satisfaction when applied in a …
subject: Research Article
  topic: section
subject: Transformational leadership, transactional leadership, job satisfaction, healthcare workers, Oman, systematic review.
  topic: keywords
creator: Rashid AL Hakamani
creator: Badriya Nasser
rights: Copyright (c) 2026 Journal of Medical and Health Studies
date: 2026-05-26
publication date: 2026-05-26
starting page: 42
ending page: 75
doi: 10.32996/jmhs.2026.7.8.4

Human-Centered Artificial Intelligence for Healthcare, Education, Business, and Assistive Technologies
type: item
description: Artificial intelligence increasingly mediates consequential human decisions across healthcare, education, business, assistive technologies, digital health, and organizational management. Yet the dominant evaluation paradigm—predictive accuracy—inadequately captures the properties most relevant to human welfare: interpretability, usability, accessibility, fairness, privacy, and the quality of human-AI collaboration. Human-centered AI reframes AI development as a socio-technical design discipline in which model outputs must support—rather than supplant—human expertise, judgment, and agency. This structured critical review synthesizes an eight-axis human-centered taxonomy covering domain, function, data modality, architecture family, design concern, deployment pathway, evidence role, and evidence maturity. Seven human-centered domains are examined: healthcare and biomedical decision support, education and adaptive learning, assistive technologies and accessibility, neuro-affective and mental-health AI, business and organizational decision-making, human-facing IoT and smart infrastructure, and cybersecurity and trustworthy digital systems. Synthesis reveals that while AI architectures have advanced substantially across vision transformers, hybrid ensembles, graph neural networks, and federated systems, human-centered design properties—validated explainability, inclusive design, privacy-preserving deployment, affective ambiguity management, and governance accountability—remain inconsistently addressed. An eleven-direction research agenda emphasizes human-centered evaluation, user-driven validation, fairness-aware design, accessible deployment, and governance-ready AI systems across all critical domains.
subject: Research Article
  topic: section
subject: privacy-preserving AI, federated learning, edge-cloud computing, distributed intelligence, scalable decision support, critical applications, trustworthy AI, deployment readiness
  topic: keywords
creator: Mst Rafia Jannat
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0
date: 2026-05-24
publication date: 2026-05-24
starting page: 29
ending page: 41
doi: 10.32996/jmhs.2026.7.8.3

Deployable AI Systems for Healthcare, Industry, Business, and Smart Infrastructure: A Cross-Domain Review
type: item
description: Artificial intelligence has progressed from laboratory benchmark systems to operational tools embedded in healthcare diagnostics, industrial monitoring, business analytics, smart infrastructure, agriculture, cybersecurity, and assistive technologies. However, the transition from a high-performing model to a deployable AI system remains a persistent challenge: clinical, industrial, and organizational deployment requires far more than predictive accuracy, demanding workflow integration, data interoperability, real-time feasibility, explainability, privacy, security, governance, and sustained post-deployment maintenance. This structured critical review synthesizes using a six-axis deployment-centered taxonomy encompassing application domain, data modality, architecture family, deployment pathway, deployment-readiness concern, and decision-support function. Seven application domains are examined: healthcare and biomedical AI, human-centered and assistive AI, industrial monitoring and cyber-physical systems, smart infrastructure and IoT, agriculture and sustainability, business and enterprise analytics, and cybersecurity and distributed intelligence. Eight architecture families are characterized, from conventional machine learning and CNNs through vision transformers, graph neural networks, Bayesian physics-guided models, generative AI, and federated learning systems, each associated with distinct deployment constraints and trustworthiness requirements. Synthesis identifies recurrent cross-domain deployment gaps including validated explainability, uncertainty quantification, privacy-preserving inference at scale, lightweight edge deployment, evidence maturity, and governance-aligned reporting. A structured future research agenda addresses these gaps with actionable directions and evaluation requirements. This review provides researchers, engineers, and practitioners with a deployment-focused roadmap for building AI systems that are not only capable but trustworthy, susta…
subject: Research Article
  topic: section
subject: Deployable AI, AI deployment, Clinical AI, Edge AI, Federated learning; Explainable AI, Industrial AI, Cross-domain deployment taxonomy.
  topic: keywords
creator: FNU Nurujjaman
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by-nc/4.0
date: 2026-05-24
publication date: 2026-05-24
starting page: 14
ending page: 28
doi: 10.32996/jmhs.2026.7.8.2

AI-Enabled Resilient Systems: Healthcare, Sustainability, Cybersecurity, Energy, and Organizational Decision-Making
type: item
description: Resilience, the ability of a system to support continuity, adaptation, risk awareness, and recovery under uncertainty or disruption, has emerged as a central requirement for AI-enabled decision systems across critical domains. Healthcare systems must sustain diagnostic accuracy and patient privacy under data constraints and clinical heterogeneity. Energy and infrastructure systems must maintain monitoring reliability under sensor drift and communication instability. Cybersecurity systems must protect data and detect threats in adversarial environments. Agricultural and sustainability systems must function in variable field conditions with constrained hardware. Business and organizational systems must remain agile under economic volatility and pressure of governance. Human-centered AI systems must preserve accessibility, personalization, and ethical oversight for vulnerable users. This structured critical review synthesizes a curated corpus using a seven-axis resilience taxonomy encompassing resilience domain, resilience function, data modality, architecture family, system layer, deployment concern, and decision-support level. Seven resilience domains are examined and mapped across architecture families from conventional ML and CNNs through vision transformers, graph neural networks, physics-guided Bayesian models, generative AI, and federated privacy-preserving systems. Synthesis reveals that while AI capability has advanced substantially, resilience-specific properties robustness, uncertainty quantification, privacy-preserving collaboration, post-deployment monitoring, and governance accountability—remain inconsistently addressed. A twelve-direction research agenda addresses these gaps with actionable future directions and evaluation requirements for AI-enabled resilient systems.
subject: Research Article
  topic: section
subject: AI resilience; Healthcare AI, Sustainability AI, Cybersecurity AI, Federated learning, Trustworthy AI, Organizational decision-making, Cross-domain AI taxonomy
  topic: keywords
creator: Mst Rafia Jannat
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0
date: 2026-05-24
publication date: 2026-05-24
starting page: 01
ending page: 13
doi: 10.32996/jmhs.2026.7.8.1

Magnetic Resonance Imaging Patterns of Complex Anal Fistula: A Case Series- MRI of complex anal fistula
type: item
description: Complex anal fistula requires accurate preoperative mapping because unrecognized secondary tracts, supralevator extension, and abscesses increase the risk of persistent sepsis and recurrence. Magnetic resonance imaging (MRI) is central to defining fistula anatomy and guiding surgical planning. Case presentation: We describe four male patients aged 17-46 years who presented with persistent or recurrent perianal discharge. Pelvic MRI demonstrated transsphincteric fistulas in all cases. The imaging spectrum included multiple internal openings, bilateral external openings, branching secondary tracts, extension to the levator ani, pelvic sidewall or periprostatic region, circumferential perirectal inflammatory collections, perineal abscess close to the corpus spongiosum, gas-containing fistulous tracts, and horseshoe abscess involving the intersphincteric and supralevator spaces. MRI consistently depicted low signal intensity on T1-weighted images, high signal intensity on T2-weighted and fat-suppressed T2-weighted images, and marked rim or wall enhancement after gadolinium administration. Surgical management was individualized and included abscess drainage, excision of fibrotic fistula tracts, seton placement, and laser fistula treatment. Conclusion: This case series highlights the wide anatomical variability of complex anal fistulas and the practical value of MRI in demonstrating occult branches and abscesses. Structured MRI reporting using clock-face location, relationship to sphincters and levator ani, internal and external openings, and associated collections can improve communication between radiologists and surgeons.
subject: Research Article
  topic: section
subject: Anal fistula; perianal fistula; magnetic resonance imaging; transsphincteric fistula; horseshoe abscess
  topic: keywords
creator: Chi Phong Nguyen
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by-nc/4.0
date: 2026-05-22
publication date: 2026-05-22
starting page: 115
ending page: 119
doi: 10.32996/jmhs.2027.7.7.13