Global Journal of Medicine & Public Health

HPV Vaccine awareness and acceptance: Survey among medical students

2025-12-07T16:39:56+00:00

Introduction

Human Papillomavirus (HPV) vaccine is a crucial tool in preventing certain types of cancer and other diseases. CDC

recommends vaccination for everyone through age 26 years if not adequately vaccinated when

younger. Awareness and acceptance of this vaccine plays crucial role in prevention. Future doctors should be aware

of the importance and benefits of the HPV vaccine. Higher vaccine acceptance among medical students can

contribute to higher vaccination rates in public.

Objectives

1.To study the level of awareness of HPV vaccination among medical students. 2. To know the various barriers of

HPV vaccine uptake.

Methods

It was descriptive cross-sectional study conducted at tertiary care teaching hospital. Study participants were

medical students. Study duration was from October 2024 – March 2025. Universal sampling was used. Data was

collected through google form questionnaire circulated in online Whats App platform and analyzed.

Results

Total responses received were 543. Mean age of the participants was 20.67 ± 1.71 years. Research findings showed

that 97.24 %(C.I.- 95.48% to 98.45%) participants were having awareness regarding HPV vaccination. 95.58% (C.I.-

93.49% to 97.15%) were aware of vaccine role in prevention of cervical cancer but majority were not aware of its

protective role in other diseases. Majority, 75.14%(C.I. – 71.28% to 78.72%) had not taken the vaccine. Barriers for

HPV vaccine uptake were insufficient knowledge about the vaccine in 31.18%, concerns regarding safety of the

vaccine in 12.03%, 11.58% said it was not available and 10.91% were not sure about the benefits.

Conclusion

Though awareness of HPV vaccination is present, a significant portion of medical students were not vaccinated

against HPV. Lack of accurate knowledge, doubts about safety and benefits among medical students were the main

barriers of the vaccine uptake. As India is planning to roll out this vaccine in National Immunization schedule,

overcoming barriers in medical students who will be future medical professionals is of utmost importance.

Awareness and Uptake of Janani Shishu Suraksha Karyakram Scheme among the Women Attending a Tertiary Care Hospital - A Cross-Sectional Study

2025-12-07T16:48:05+00:00

Background

Maternal mortality continues to be a pressing issue in India, necessitating ongoing efforts to improve maternal

health and reduce the Maternal Mortality Ratio (MMR). Launched in 2011, the Janani Shishu Suraksha Karyakram

(JSSK) is a significant initiative by the Government of India aimed at providing free and cashless healthcare services

to pregnant women and newborns.

Objective

This study examines the awareness and uptake of the JSSK scheme among women attending a tertiary care hospital

in Udaipur.

Methodology

A hospital-based cross-sectional study was conducted at Pannadhay Zanana Hospital, MBGH, Udaipur, over six

months. A total of 260 women meeting the inclusion criteria participated. Data were collected using a semi

structured questionnaire, assessing awareness and uptake of the JSSK scheme. Descriptive statistics and inferential

analysis were performed using SPSS v21, with significance set at P<0.05.

Results

The majority of participants (70.8%) were aged 20-30 years. Literacy rates were high, with 79.2% of participants

being literate. Most participants (93.1%) were unemployed, and 75.4% resided in rural areas. Socioeconomic

analysis showed that 45.4% belonged to the lower middle class. Awareness of the JSSK scheme was nearly universal

(99.6%), with high utilization rates (98.5%). Family members were the primary source of information about the

scheme (71.0%).

Conclusion

The JSSK scheme has successfully reached a significant portion of its target population, demonstrating high

awareness and utilization among women attending tertiary care in Udaipur.

Evaluation of serological diagnostic tests for Leptospirosis-A retrospective study

2025-12-07T16:57:09+00:00

Introduction

Leptospirosis is an emerging zoonotic bacterial infection that remains a major public health problem in tropical and

subtropical regions majorly in coastal regions ofIndia. Laboratory diagnosis of leptospirosis is mandatory because

of varied clinical picture and existence of similar infections in endemic regions which cause confusion in the

diagnosis. We evaluated and analyzed two immunodiagnostic test, Leptocheck WB-Rapid

immunochromatography test and Leptospira IgM ELISA (Panbio) test detecting Ig M antibodies (Ab) for Leptospira

in serum and compared with MAT (Microscopic agglutination test) test.

Materials and Methods

Blood samples from suspected patients of leptospirosis were tested by ELISA and Rapid test for IgM Ab detection

and MAT test from January 2022 to December 2023. The data were entered in Microsoft Excel and analyzed using

Epi Info software version 3.5.1. Descriptive analysis based on bivariant and multi-variant analysis was done. Chi

square test was applied and p-value found to demonstrate association between the tests.

Results

Out of 75 blood samples tested, 29 were positive by three different serological tests. ELISA and rapid test on

comparison with MAT showed 96.29%, 85.18% of sensitivity respectively and 93.75% of specificity. Predominant

serovar identified from MAT were L.Automonalis (77%) L. Australis (77%). Conclusion: This study suggests that

diagnostic accuracy of IgM ELISA for leptospirosis is sensitive in acute stage of the thedisease. Immunodiagnostic

methods are simple and easy to perform in detecting IgM antibody in acute phase compared to MAT in resource

limited settings.

Diagnostic potential of inflammatory markers in tuberculous pleural effusion: a prospective tertiary hospital study

2025-12-07T17:02:59+00:00

Introduction

Background and Objectives

India is an endemic country for TB Tuberculosis(TB), with the pleura being the most common extra pulmonary site

affected, followed by lymph nodes. Diagnosing EPTB Extrapulmonary Tuberculosis( EPTB)is as crucial as treating

it, since many cases are often neglected or improperly managed outside medical college hospitals. The objective of

my study is to compare the diagnostic accuracy of the Neutrophil lymphocyte ratio (NLR) with that of isolated

pleural fluid ADA Adenosine deaminase(ADA) levels in lymphocyte predominant effusions.

Methods

This is a prospective study conducted after ethical clearance and collected patient data, including demographics,

vital signs, laboratory test results, and imaging. Under aseptic conditions diagnostic and and therapeutic

pleurocentesis was performed for the patients after their informed consent. Pleural fluid for NLR was compared

with standard ADA alone in high pre-test probability (exudative lymphocytic predominant). Patients were followed

up after a month of starting ATT ( Anti Tuberculosis Treatment ), to assess clinical response by repeat imaging.

Results

A total of 54 patients among 80 patients who met the inclusion criteria ,with exudative pleural effusion was included

in the study. The mean neutrophil-lymphocyte ratio value was significantly lower in tuberculous pleural effusion.

NLR cut off was plotted with Receiver Operating Characteristic (ROC) curve with sensitivity and specificity

calculated.

Conclusion

The pleural fluid neutrophil-lymphocyte ratio, which is an inexpensive, reproducible, and easily calculated

haematological parameter when tested with ADA, synergistically increases the diagnostic accuracy.

The impact of menstruation on the well-being of female students in a private higher education institution in South Africa- A qualitative study

2025-12-07T17:17:54+00:00

Introduction

Menstrual health needs to be recognized as a health issue, and not only as a hygiene problem. It affects the health

and wellbeing of women, especially young women in higher education institutions. It leads to absenteeism and

further adds to the existing high stress that students already have. Therefore, this study sought to explore the

impacts of menstrual health/ menstruation on the well-being and academic performance of students in a private

higher education institution in South Africa.

Methods

A case study was conducted using a qualitative approach. A total of 10 female students from a private higher

education institution, a private higher Institution in South Africa were interviewed using the in-depth semi

structured interview method. The participants’ age ranged from 20 to 24 years old and the average age of

menarche was 13 years old. Thematic analysis was used to analyse that data collected,

Results

Six themes were generated and these included, i) Negative menstrual experiences, ii) Perception on physical

appearance, iii) Impact on mental wellbeing, iv) Impact of academic performance and v) Coping mechanisms and

vi) Recommendations proposed by the participants.

Conclusion

The study showed that menstruation could affect mental, physical and social wellbeing of higher education

institution of students. As the focus was on female students, a supportive environment is required to educate and

support those using effective strategies to benefit their academic performance. It is also important to understand

the coping mechanism adopted by female students towards their menstrual health. This will help with the decision

making by the policy makers.

Prevalence and Determinants of poor Glycemic Control in adults with Type 2 Diabetes Mellitus: A study from an urban population in Nadia district

2025-12-07T17:21:51+00:00

Background

India is known as the "diabetic capital of the world" and has the second-highest rate of adult diabetes globally. One

of the main causes of the diabetes epidemic in India is urbanisation. In patients with Type 2 diabetes, inadequate

glycaemic management is a major public health concern and a major risk factor for the disease's progression and

complications. Therefore, the purpose of this study is to evaluate the glycaemic control status and factors that

contribute to poor glycaemic control in individuals with type 2 diabetes.

Materials and Methods

This is a cross-sectional study done over a period of four months, among patients with T2DM attending the College

of Medicine and JNM hospital, Kalyani and UHTC Chakdah State General Hospital, Nadia district, West Bengal,

using a pre-tested semi-structured questionnaire. A total of 200 patients with T2DM who had the latest reports of

fasting blood sugar values were included in the study. SPSS version 26 was used to analyse the collected data and

to identify the determinants and risk factors leading to poor glycaemic control.

Results

Of the 200 study participants, 62.5% had poor glycaemic control. The mean FBS value of the study group was 145.59

± 42.57 mg/dL. Further, it was found that irregular check-ups, type of medication, and non-adherence to a diabetic

diet were risk factors for poor glycaemic status.

Conclusion

It was shown that a significant number of diabetics had poor glycaemic control; therefore, to effectively manage

this condition and lessen the burden of the disease, appropriate health education, diabetes counselling, and the

planning of health awareness programs are required.

Introduction of reflective writing as a Learning Tool for community visits under family adoption programme

2025-12-07T17:27:09+00:00

Introduction

Competency based curriculum for medical undergraduate students considers reflective writing as an essential

aspect pertaining to self-directed learning. Reflective writing during community visits helps medical undergraduate

in developing the habit of questioning themselves and subsequently finding solutions pertaining to various

community based health care.

Aim and Objectives

To explore reflective writing skills during family visits by undergraduate medical students and assess reflective

writing skills after sensitization to a reflective writing model

Methods

The cross-sectional study was conducted in the department of Community Medicine among Phase I and II medical

undergraduate students. After completing their family visits, students from both batches were asked to write

reflections using google form based on Gibbs reflective cycle. This was followed by sensitization session for writing

reflections based on various components of Gibbs cycle. Following the session, students repeated the process of

writing down reflections. The level of reflective writing was assessed by using validated rubric based scale for

Application, Depth, Quality and Structure for various components of Gibb’s reflective cycle (Description, Feeling,

Evaluation, Analysis, Conclusion, Action plan). For grading, five point rubric based scale was used. Satisfaction level

for the use of this model for reflective writing by students was determined on Four point Likert scale.

Results

All the mean scores before and after sensitization session were statistically significant within phase I & II students

(p<0.001). Comparative rubric based analysis for phase I and phase II MBBS students for various parameters of

Gibb’s Reflective cycle model (Application, Depth of Reflection, Quality of information, Structure & organization

showed significant differences with scores higher for phase II students as compared to phase I (p<0.001). The

assessment of satisfaction levels for using Gibbs reflective writing model revealed that 54 students (90%) students

were satisfied from phase I MBBS while 81students (93%) were satisfied from phase II.

Conclusion

Gibbs’ Reflective Writing Model was well-received by MBBS students, with high satisfaction levels reported in both

Phase I and Phase II. The findings highlight the importance of reflective practice in medical education and suggest

that structured reflection can be a valuable tool for enhancing learning and professional development.

The Impact of Blue-Green Infrastructure on Morbidity and Mortality during Extreme Heat

2025-12-07T17:31:42+00:00

ABSTRACT

Background

Extreme heat events are one of the deadliest effects of our changing climate. Blue-green infrastructure aids

with ambient temperature regulation and has an overall positive effect on human health. Studies

documenting the impact of blue-green infrastructure on human health during extreme heat are fragmented

across multiple disciplines, with no current synthesis completed.

Objective

To examine the current evidence regarding the impact of blue-green infrastructures on human morbidity and

mortality during extreme heat.

Methodology

A PubMed literature review search was conducted in June 2024 using 13 common terms to describe blue-green

infrastructure, five terms for extreme heat, plus health. Included studies evaluated a blue-green infrastructure

variable and health outcome during measured extreme heat. Non-in situ human research was excluded.

Synthesization was conducted using an ecosystems service theoretical framework.

Results

The PubMed search terms yielded 145 articles, 124 did not meet the necessary criteria, and 21 were synthesized.

Sixty-seven percent showed a statistically significant (p-values 0.001 to 0.05) direct association between blue

green infrastructure presence and health outcomes during extreme heat. Mortality rate and mental health were

studied most frequently. An additional 19% of studies found similar statistically nonsignificant trends. Three

studies found no consistent interaction

Conclusion

Blue-green infrastructure may play a critical protective role for human health during extreme heat.

Public health implications

Blue-green infrastructure is an economically accessible and sustainable method of mitigating many of the effects

of climate change, including water management and lowered surface temperatures. While its impact on health is

likely multifactorial, its protective role on morbidity and other health outcomes during heat waves should be

embraced as a viable part of future public health climate resiliency plans.

A Cross-sectional study on awareness and factors influencing use of Home Blood Pressure Monitoring

2025-12-07T17:37:01+00:00

Background

Home blood pressure monitoring (HBPM), whether guided by patients or clinicians, is increasingly acknowledged

as an effective method for improving blood pressure control in hypertension. Compared to clinic measurements,

HBPM offers more reproducible readings and better predicts cardiovascular mortality. Additional benefits include

convenience, the ability to take repeated readings over time, reduced white coat effect, and enhanced patient

involvement in managing their condition.

Objective

To assess the awareness gap regarding home blood pressure monitoring interventions among hypertensive

individuals and factors influencing it.

Methods

A cross-sectional study was conducted among 235 adults >18 years of age adult patients attending field practice

area of tertiary care center for a period of 1 year amongst who are diagnosed as hypertensives on regular treatment

for at least three months. Pré-designed, pre-tested, Pré-validated questionnaire was used. Data was collected on

various parameters, including gender, education, socioeconomic status, cost of the blood pressure (BP) apparatus,

awareness regarding home blood pressure monitoring (HBPM), and proficiency or lack of training in performing

HBPM.The collected data were entered in excel and analyzed using Microsoft Office 365. Categorical variables were

assessed for statistical significance using the chi-square test. Permission was taken from Institutional Ethics

Committee.

Results

Among the 235 participants, 18.3% had been diagnosed with hypertension for less than six months, 16.2% for six

months to one year, and the majority, 65.5%, for more than one year. In terms of healthcare preference, 30% opted

for government facilities, while 70% chose private ones. Regarding home blood pressure monitoring (HBPM), 107

participants were aware of it, but only 59 reported actually using it. The most common reason for not using HBPM,

cited by 38.3% was a lack of knowledge on how to operate the device. Additionally, 28.1% felt it was necessary, and

8.5% identified the cost of the equipment as a barrier.

Conclusion

Home blood pressure monitoring (HBPM) is an effective tool for managing hypertension, offering more reliable

readings than clinic measurements and better predicting cardiovascular risk. It also provides convenience,

minimizes white coat effect, allows repeated measurements, and promotes patient engagement.

Assessment of Anxiety Disorder in First Year Undergraduate Students of a Medical College in Ahmedabad, Gujarat,India

2025-12-07T17:42:18+00:00

ABSTRACT

Introduction: Medical education is competitive across the globe. It is considered to be one of the most academically

and emotionally demanding training programs out of any profession.

Objectives: Assessment of level of anxiety amongst newly admitted first year undergraduate medical students.

Methods: Cross sectional study was carried out amongst students by using a pre-designed and pre-tested, semi

structured questionnaire. Hamilton Anxiety Rating scale (HAM-A) was used for assessing the level of anxiety.

Google form was prepared and explained to the students and responses were collected.. 167 students participated

in this research.

Result: Out of total 167 students,75(44.91%) were boys and 92(55.09%) were girls. Mean age of boys and girls was

18.16 + 0.77 and 17.91 + 0.77 years respectively.103(61.68%) were residing in hostels. Forty (53.33%) boys and

36(39.13%) girls had no anxiety ,35(46.67%) boys and 53(57.61%) girls had mild anxiety, none of boys have moderate

to severe type of anxiety, 2(2.17%) girls have moderate type of anxiety and 1(1.08%) girl has severe type of

anxiety.Fifty- nine (35.33%) students are using relaxation method to relieve anxiety. The mean HAM-A score was

7.42 ± 3.65, indicating mild anxiety levels overall. There is no significant difference in anxiety levels as per age,

gender, type of residence and different living situation.

Conclusion: Though the anxiety level as assess by HAM-A scale amongst the medical students was high but the

overall mean score of anxiety was very low and all had only mild level of anxiety. These findings highlight the

importance of early psychological orientation and stress management sessions to help students adapt to the

demanding medical curriculum.

Prevalence of Depression among nursing staff in a tertiary care hospital in Wayanad, Kerala: An observational study

2025-12-07T17:51:51+00:00

Depression is a significant global health issue, affecting over 350 million individuals. A population-based study in

India reported a 15.1% prevalence of depression. Nurses play a crucial role in healthcare, and their well-being

directly impacts hospital quality, making their mental health an essential concern.

Objectives-To estimate the prevalence of depression among nursing staff of a tertiary healthcare hospital. To

determine the association between depression and the sociodemographic factors influencing poor mental health.

Methodology-This was a cross-sectional observational study conducted among 201 nursing staff in a tertiary

healthcare hospital in Wayanad district of Kerala. Study was conducted between July 2024 to September 2024 by

complete enumeration method. A standardized Beck’s Depression Inventory Questionnaire was used to assess the

severity of depression among nursing staff.

Results

The mean age of nursing staff was 30.22 ± 6.49 years; 86% were women, and 14% were men. The majority were

Christians (44%). 42% of the study subjects were married and 54% were unmarried. 66% belonged to nuclear families,

22% to extended nuclear families, and 12% to joint families.35.2% (71) were normal, while 45.27 % had depression—

19.40%(39) mild mood disturbance,12.43% (25) borderline clinical depression, 16.91% (34) moderate, 12.43% (25)

severe, and 3.48% (7) extremely severe depression. Depression was linked to sex, age, marital status, work

experience, time spent with friends and distance of hospital from home.

Conclusion

Our study reveals that there is significant prevalence of depression among nursing staff and there is association of

depression with sociodemographic factors which can impact the Quality of service. Also due to the personal life and

the difficulties faced such as increased distance from home, marital status, time spent with friends, etc, there can be

a negative impact on professional life.

Estimation of serum magnesium levels in stable and acute exacerbation of bronchial asthma and its correlation with disease severity. A cross-sectional study

2025-12-07T18:00:24+00:00

Background

Magnesium sulfate (MgSO?) is widely used in managing acute exacerbations of bronchial asthma, especially in

refractory cases. However, hypomagnesemia remains an under recognized electrolyte abnormality, often

overlooked in routine asthma care. This study aims to assess serum magnesium levels in patients with bronchial

asthma—both in stable condition and during acute exacerbations—and to explore its correlation with asthma

severity.

Materials and Methods

This cross-sectional study was carried out at a tertiary care center in Thrissur, Kerala, with a total of 80 participants.

Patients were divided into two main groups: Group A (Stable Asthma): Subdivided into well-controlled, partially

controlled, and uncontrolled asthma based on the GINA symptom assessment. Group B (Acute Exacerbation):

Further classified into mild to moderate and severe asthma based on clinical assessment. Serum magnesium levels

were measured at the time of presentation for all patients.

Results

The findings showed a statistically significant reduction in mean serum magnesium levels among patients with

acute exacerbations (1.71 ± 0.16 mg/dL). Among those with stable asthma, patients with uncontrolled asthma had

lower magnesium levels (1.85 ± 0.16 mg/dL) compared to those with partially controlled (2.06 ± 0.14 mg/dL) and

well-controlled asthma (2.08 ± 0.14 mg/dL).

Conclusion

Serum magnesium levels were notably lower in asthmatic patients with higher disease severity. These findings

suggest that monitoring and correcting magnesium deficiency could potentially improve asthma control and

reduce exacerbations.

Preparedness and response to outbreaks in port of entries: A case of Ebola Virus Disease at Julius Nyerere International Airport, Tanzania

2025-12-07T18:06:49+00:00

Background

Preparedness and response to outbreak remain a major means for the prevention and control of outbreaks including

Ebola Virus Disease (EVD). Although Tanzania has not being seriously hit by EVD in the past few decades, some of

the neighboring countries have been badly hit. The disease is highly contagious and easily transmitted through

human-to-human transmission. Port of entries in countries remains the major point of focus especially when a

neighboring country having an outbreak.

Objective

To explore challenges facing preparedness of port of entries in Tanzania on prevention and control of outbreaks

from the experiences of Julius Nyerere International Airport (JNIA) during the 2018 EVD outbreak in Congo (DRC)

Methods

We conducted nine in-depth interviews with officials from departments of Health, Immigration, Airport Authority

and members of Comprehensive Emergency Preparedness and Response Team at JNIA to explore the challenges

facing preparedness and response to EVD. A hybrid thematic analysis was employed for the data analysis.

Findings

Limited EVD information sharing among Emergency Comprehensive Team, inadequacy staff for EVD

preparedness, poor coordination of resources for EVD response, limited capacity building opportunities for staff at

JNIA, inappropriate utilization of isolation place, and limited transport capacity for referral cases were the major

challenges facing preparedness and response for prevention and control of outbreak at JNIA.

Conclusion

Preparedness of EVD at JNIA, the largest international airport in Tanzania faces many challenges. Coordination of

resources, strengthening the communication system for outbreaks and capacity building to staff at port of entries

are recommended initial steps in strengthening preparedness and response to outbreak. This small-scale study calls

for further studies to explore preparedness and response to outbreaks in port of entries in Tanzania.

The Risk of Micromanagement in Healthcare

2025-12-08T16:28:52+00:00

Healthcare leaders carry enormous responsibility. They are accountable for compliance, patient safety, quality

metrics, and financial performance. With so much at stake, it is tempting to believe that tighter control guarantees

better results. Yet in quality improvement (QI), micromanagement is not a safeguard; it is a barrier. Sustainable

improvement requires leaders who are change-ready, willing to delegate authority, and able to trust their staff to

drive solutions creatively.

When Control Becomes Constraint

Micromanagement often stems from good intentions. Leaders seek consistency, accountability, and assurance that

improvement projects will not drift off course. During moments of crisis, such as patient safety incidents or

regulatory reviews, closing oversight may be necessary. However, when micromanagement becomes the default

leadership style, it undermines the very people who are closest to work and best positioned to identify meaningful

improvements. Frontline staff, including providers, nurses, medical assistants, care coordinators, and registration

clerks, experience the inefficiencies and bottlenecks that leaders rarely see firsthand. Yet under micromanagement,

their ideas are delayed, dismissed, or overridden. Instead of cultivating ownership, the organization cultivates

compliance. Instead of fostering creativity, it produces caution. As I noted in Mastering Healthcare Consulting: The

Consultant’s Playbook, “Change often provokes skepticism or resistance, particularly in healthcare, where

established routines, procedures, and hierarchies are integral to daily operations. This resistance can arise from fear

of the unknown, perceived threats to job security, or concerns about increased workload.”¹ Micromanagement

amplifies those fears and leaves staff disengaged at the very moment when their insight is most needed.

The False Comfort of Micromanagement

There is a common argument that micromanagement ensures standardization and prevents mistakes. In practice,

this is a false comfort. Over-control may yield short-term compliance, but it suffocates long-term improvement.

Teams learn to wait for permission rather than solve problems. Innovation slows. Engagement erodes. And the

burden of decision-making concentrates at the top, which is unsustainable for leaders and toxic for the culture.

What Change-Ready Leadership Looks Like

Effective leaders recognize that QI is not simply a technical exercise but an organizational change process. Change

ready leadership is characterized by setting vision, granting autonomy, and creating the conditions for

psychological safety. Leaders define the “why” and the intended outcomes, while staff are entrusted with

determining the “how.” This aligns with well-known change frameworks that emphasize urgency, coalitions, skills

development, and reinforcement.²,?

In The Consultant’s Playbook, I emphasize: “Involve key stakeholders from the beginning to foster a sense of

ownership. Use their insights to tailor solutions and build trust across teams.”¹ Ownership and trust are antidotes

to micromanagement. They transform reluctant staff into committed partners in improvement.

Change-ready leaders:

? Set the vision, not every step. Provide clarity of purpose and outcomes but allow flexibility in

implementation.

? Delegate with trust. Empower staff to design, test, and refine solutions in real time.

? Create psychological safety. Encourage experimentation, accept early failures as learning, and celebrate

small wins.

? Intervene only when necessary. Step in when patient safety, compliance, or strategic alignment are at risk,

rather than managing every detail.

When Control Turns Toxic

Micromanagement becomes toxic when staff are consistently excluded from decision-making about the processes

they carry out daily. Creativity is discouraged in favor of rigid adherence to rules. Leadership overrides staff input

without explanation. Obedience rather than outcomes judge performance. The result is predictable:

disengagement, stalled innovation, and organizational inertia.Editorial

Helen Dao et al.

www.gjmedph.com Vol. 14, No.4, 2025 ISSN# 2277-9604

A Call to Leaders

Healthcare does not lack improvement frameworks. From Plan-Do-Study-Act cycles to Lean and Six Sigma, proven

tools exist. What many organizations lack is leadership that trusts staff to act on these methods. Micromanagement

provides only the illusion of control while eroding the foundation of improvement.

Delegating authority, empowering creativity, and releasing unnecessary control are not signs of weakness; they are

hallmarks of change-ready leadership. If healthcare organizations want improvement that lasts, leaders must

empower staff to lead from their current positions. Sustainable quality depends not on rigid oversight, but on trust,

flexibility, and a willingness to share control.

Assessing the Impact of Ommaya Reservoirs in Combination with External Ventricular Drainage Therapy on Intraventricular Haemorrhage:A Retrospective Analysis

2025-12-08T16:34:05+00:00

Introduction

Intraventricular hemorrhage (IVH) is a serious complication of various neurological conditions that can lead to

increased intracranial pressure, hydrocephalus, and poor neurological outcomes. External ventricular drainage

(EVD) systems are commonly used for managing IVH by draining cerebrospinal fluid (CSF) and blood from the

ventricles of the brain. However, the optimal EVD system for managing IVH is still debated. This study aims to

evaluate the influence of combining Ommaya reservoirs with external ventricular drainage (EVD) therapy in

patients diagnosed with intraventricular hemorrhage (IVH).

Methods

A total of 20 patients with IVH were included in this retrospective study, with 10 patients receiving dual catheters

(EVD with Ommaya) and 10 patients receiving single catheter EVD. The patient characteristics, IVH volume, mean

arterial pressure (MAP), amount of CSF drainage, modified Graeb score (mGS), Glasgow Outcome Scale (GOS)

score, duration of drainage, ICU length of stay, and mortality rate were compared between the two groups. Data

Analysis was performed to compare outcomes, clinical markers, and imaging findings between the Ommaya

utilized and Ommaya-unused groups. Anticipated findings will shed light on the significance of Ommaya reservoir

utilization in conjunction with EVD therapy for IVH patients. Additionally, the study aims to identify specific clinical

markers that can aid in the decision-making process regarding Ommaya reservoir implantation.

Results

Both groups had similar demographic and clinical features in this trial comparing dual catheters (EVD with

Ommaya) against single catheter drainage for intraventricular hemorrhage. The IVH volume was larger in the dual

catheter group (EVD with Ommaya), while the MAP was lower. The dual catheter group had a considerably lower

mean mGS score at the follow-up scan than the single catheter group. The dual catheter group required no

repositioning and had a shorter period of drainage. The dual catheter group had a decreased mortality rate and a

higher GOS score after 30 days. The reduction in mGS score was considerable in the dual catheter group, particularly

in individuals with mGS scores ranging from 15 to 25. Considering the fact that the sample size was small and no

statistical analysis was provided.

Conclusion

Dual catheter EVD systems may be more effective than single catheter systems for managing IVH, as they were

associated with a greater reduction in mGS score, higher GOS score, shorter duration of drainage, and lower

mortality rate. and less repositioning/recatherization However, greater sample size studies and statistical analysis

are required to corroborate these findings.

In Utero Exposure to Preeclampsia and Cardiometabolic Risk: A Review of Literature

2025-12-08T16:38:56+00:00

ABSTRACT

Preeclampsia is a hypertensive disorder that occurs during pregnancy, affecting 3-5% of pregnancies globally and

is an independent cardiovascular risk factor for the mother, and recent studies reveal that offspring of affected

pregnancies may also have an increased risk for developing cardiovascular diseases (Karrar and Hong, 2022). This

is referred to as foetal programming and is said to be related to several factors (Davies et al., 2017). Therefore, this

study focuses on the cardiometabolic risks endured by offspring of preeclamptic pregnancies

Endoscopic versus Microscopic Type 1 tympanoplasty – Comparison of surgical outcomes

2025-12-08T16:55:48+00:00

Objective

This study aims to compare the surgical outcomes of type 1 tympanoplasty performed with endoscopic and

microscopic techniques. It aims to compare the outcomes in terms of hearing restoration and graft success rates. It

also assesses differences in postoperative pain and operative time.

Methods

A prospective study conducted over 8 months included 84 patients, divided into two groups: 42 undergoing

microscopic tympanoplasty (postaural approach) and 42 undergoing endoscopic tympanoplasty (endomeatal

approach), using temporalis fascia graft. Preoperative and postoperative hearing were evaluated through pure tone

audiometry. Post operative hearing improvement and graft success was assessed at 3 months. Postoperative pain

was measured using a numerical rating scale at immediate and 1-week follow-ups.

Results

Both groups demonstrated similar graft success rates (microscopic 95.23%, endoscopic 92.86%) with no significant

difference in hearing improvement or air-bone gap closure. However, the endoscopic group had significantly

shorter operation times (mean 65.12 minutes) and less postoperative pain (immediate and at 1-week follow-up)

compared to the microscopic group (mean operation time 82.17 minutes, higher pain scores).

Conclusion

Endoscopic tympanoplasty offers comparable graft success and hearing outcomes to the microscopic approach

while providing the advantages of shorter operation time and reduced postoperative pain. These findings support

the growing preference for endoscopic techniques in minimally invasive middle ear surgeries.