INTRODUCTION: This study examines factors influencing Primary Health Care (PHC) utilization in Margibi County, Liberia, with a focus on urban-rural disparities.
METHODS: A cross-sectional survey was conducted among 900 adults (urban: 49.7%, rural: 50.3%) who had lived in the county for at least two years. Data were collected using a two-stage cluster sampling technique and structured interviews, then analyzed using descriptive and inferential statistics.
RESULTS: Findings revealed significantly higher PHC utilization in urban areas (79.6%) than in rural areas (62.5%), with 29% of participants not accessing PHC services. Key determinants included residential location, age, employment, income, media exposure, and proximity to health facilities. Rural residents faced barriers such as long travel distances and lower income, leading to reduced vaccination rates, poorer maternal health, and a higher disease burden.
DISCUSSION AND CONCLUSION: Addressing these disparities requires targeted policies to strengthen healthcare infrastructure and service delivery, particularly in rural areas. Improving PHC accessibility is essential for reducing health inequities and enhancing overall health outcomes in Margibi County.

INTRODUCTION: The process of empowerment gives people the ability to take command, develop self-assurance, increase awareness, increase mobility, and make decisions. Getting women's voices heard when making decisions that affect them, their families, and the community is essential to improving women's quality of life. According to an Indian study, women in both age groups have higher levels of education, are more progressive in their viewpoints, and have more influence over decisions made in the home.
METHODS: For the study, 200 Indian women in Jabalpur, Madhya Pradesh, were surveyed to find out if they were involved in healthcare decisions. The multistage random sampling technique was used. To provide information, the family's female head filled out a semi-structured questionnaire. The study was conducted in accordance with the protocol approved by the Institutional Ethics Committee.
RESULTS: A study in Jabalpur, MP, found that 42.5% of families make decisions on contraception, with women making more independent decisions about health care, shopping, and purchasing clothing and jewellery. Women's involvement in social and private affairs was low, with only 32.7% actively participating in health care decisions
DISCUSSION AND CONCLUSION: The study reveals that 85% of women have reduced autonomy in healthcare decision-making, despite having the right to participate. The findings suggest that educated partners and small families could improve women's decision-making autonomy in maternal health service use and family planning.

INTRODUCTION: This study aimed to assess the cognitive functions and dementia risk among individuals with and without metabolic syndrome who had previously contracted COVID-19, using Mini-Mental State Examination (MMSE) scores. It also aimed to support early and effective interventions for those at risk of dementia or metabolic syndrome in accordance with clinical guidelines.
METHODS: This descriptive cross-sectional study included 375 participants aged 18 years and older who visited the COVID-19 follow-up clinic. During the clinic visit, the MMSE was administered, and participants underwent blood pressure measurement, anthropometric assessment, and laboratory testing.
RESULTS: A statistically significant association was found between dementia frequency and factors such as age, education level, and female gender in the post-COVID population (95% CI; OR=1.039, p=0.001; OR=2.937, p=0.004; OR=1.793, p=0.038, respectively). Although dementia was more common among individuals with metabolic syndrome compared to those without, this relationship was not statistically significant (OR=1.347, p=0.266).
DISCUSSION AND CONCLUSION: In line with the principles of family medicine, which emphasize early recognition and community health responsibility, we recommend cognitive screening for at-risk individuals. Tools such as the MMSE, which offer valuable insights into cognitive decline, should be used proactively to improve public health outcomes.

INTRODUCTION: This study aimed to investigate eating attitudes, body image perceptions, and depression levels among medical students, a population known to face considerable mental health challenges due to the rigorous nature of medical training.
METHODS: A cross-sectional study was conducted with 359 students (205 females and 154 males) enrolled at Yozgat Bozok University's Faculty of Medicine. Participants completed self-report questionnaires assessing depressive symptoms, body image satisfaction, and eating behaviors. Sociodemographic data were also collected to explore potential risk factors.
RESULTS: Depression levels were significantly higher among female students (p < 0.001) and those originating from rural areas (p < 0.001). A considerable proportion (42.9%) of students reported dissatisfaction with their physical appearance, and 55.4% stated that others’ opinions influenced their body image. Furthermore, 79.9% indicated that their emotional states affected their eating behaviors. However, statistical analysis revealed no significant correlations between eating attitudes, body image perceptions, and depression scores.
DISCUSSION AND CONCLUSION: Although no direct relationships were observed between eating attitudes, body image, and depression, the high prevalence of psychological distress and body dissatisfaction—particularly among female and rural-background students—highlights the need for targeted mental health interventions. Addressing these issues within medical education may help enhance students’ psychological resilience and well-being, ultimately benefiting their future clinical practice.

INTRODUCTION: Based on the ultimate goals of health services and the importance of public health, health system performance evaluation should be carried out at the regional, national, or international level, the difference between expected health performance and desired health performance should be revealed, and necessary improvements should be provided. This study aims to evaluate the health system performance in the Organization of Turkic States.
METHODS: The LOPCOW method, one of the multi-criteria decision-making techniques, was used in the study for weighting the criteria and ranking the countries, and the CoCoSo method was used to reveal the rankings on the basis of countries.
RESULTS: When the LOPCOW results are analyzed, it is determined that the most important criterion is K6 (Under Five Mortality Rate) with a value of 0.1755, the least important criterion is K3 (Number of Physicians) with a value of 0.0836, while the country with the best health system performance with the integration of CoCoSo method is Hungary, Uzbekistan, Azerbaijan, Kazakhstan, Kyrgyzstan, Turkiye, Turkmenistan, respectively.
DISCUSSION AND CONCLUSION: As a result of the results of the study, it is recommended that health policy makers, planners, managers, practitioners, researchers, and service demanders gain a different perspective and determine health policy and public health strategies for these situations.

INTRODUCTION: In this study, medical school students' attitudes toward the profession of medicine, their perceptions of the values of medicine, and the relationship between these concepts were evaluated.
METHODS: This descriptive cross-sectional study was conducted at xxx University Faculty of Medicine. Participants were asked to answer the sociodemographic data form, the medical profession attitude scale, and the medical profession value perception scale.
RESULTS: 567 medical students (79.52% of all students) participated in this study. Of the participants, 58.9% were preclinical and 41.1% were clinical phase students. The mean scores of the medical profession attitude scale and the medical profession value perception scale were statistically significantly higher for those who preferred medical school willingly (p<0.001, p=0.004). The scores of the medical profession attitude scale and medical profession value perception scale decreased statistically significantly with increasing grade levels in clinical phase medical students (p<0.001, p<0.001). Statistically significant positive correlation found between the scores of the medical profession attitude scale and the scores of the value perception scale (p<0.001).
DISCUSSION AND CONCLUSION: As a result of this study, positive attitudes towards the medical profession and high perceptions of medical values were higher among those who chose the medical profession willingly. It was found that positive attitudes and value perceptions towards the medical profession decrease as students transition from the preclinical to the clinical phase. The educational processes that lead to changes in attitudes and values during medical education should be reconsidered. The sources of motivation regarding the sustainability of medical education should be evaluated.

INTRODUCTION: Because proton pump inhibitors are effective and well tolerated, their use without an appropriate indication is increasing. This raises concerns about long-term side effects.
METHODS: This cross-sectional survey study was conducted among patients using proton pump inhibitors for any reason in 4 primary care centers in Hatay province. The study included 451 participants. The statistical significance level of the data obtained was interpreted with the “p” value. p<0.05 values were considered statistically significant.
RESULTS: In this study, 39.9% of patients were using proton pump inhibitors inappropriately. 38.4% of the patients had been using proton pump inhibitors for more than 2 years. There was also a significant association between use for more than 2 years and the occurrence of side effects (p=0.001). 75.4% of the patients stated that they were not informed about the side effects of the drug. In addition, in patient-physician communication, there was a significant correlation between physician's mention of side effects and inappropriate use of proton pump inhibitors (p=0.009).
DISCUSSION AND CONCLUSION: Inappropriate proton pump inhibitors can be prevented by starting the appropriate dose of proton pump inhibitor in the patient with the necessary indication, informing the patient at the first prescription, creating a physician's plan about when to terminate proton pump inhibitors, and raising awareness of the patient about this issue.

INTRODUCTION: Although people with disabilities need health services more, they benefit less from health services. To determine the reasons for this condition, the present study examines the barriers that individuals with disabilities face in accessing health services.
METHODS: In face-to-face meetings, a sociodemographic information form and a questionnaire regarding the obstacles encountered while accessing health services were administered to individuals with disabilities or their parents living in Adana.
RESULTS: 412 disabled individuals between 0.3 and 88 years of age participated in the study. 58.98 % of the participants are men, and 41.01 % are women. While 90.29 % of participants pay for medicine, 91.02 % of participants pay for all kinds of medical supplies, and 92.96 % pay for health services. 64.3 % of participants experience stress while receiving health services. For 70.1 % of the participants, assistant personnel are not assigned in the health institution. 51.2 % of participants do not see sufficient understanding from other patients’ relatives, and 52.2% cannot use their right of priority.
DISCUSSION AND CONCLUSION: Economic conditions and social security rates of disabled individuals are low compared to those of society. The most important obstacle to the access of people with disabilities to health is economic barriers. Other obstacles are that disabled individuals experience stress in the procurement of services, parents with low education level, need their relatives for treatment, not allocating auxiliary personnel in health institutions, not having sufficient understanding from other patient relatives, and not being able to use their rights of priority.

INTRODUCTION: This cross-sectional study examines factors shaping Turkish older adults' self-perceptions of aging and health (SPAH), emphasizing sociodemographic characteristics, critical health literacy, and perceived usefulness of information and communication technologies (ICTs).
METHODS: Drawing on data from 450 participants aged 65 and over in Istanbul, this cross-sectional research employs a range of quantitative methods, including descriptive and comparative analyses, cross-tabulations, correlations, and path modeling.
RESULTS: Covariance analyses reveal a positive and significant relationship between perceptions of aging and health (B=12.143>0, p<0.001). The study's central contribution lies in uncovering a potential cognitive link between perceptions of aging and health. Path analysis also indicates that the perceived usefulness of ICTs influences critical health literacy (B=0.368, p<0.001), which in turn affects health perceptions (B=0.194, p<0.001). These results suggest that increasing the perceived usefulness of ICTs and critical health literacy can foster moderately more positive perceptions of aging and health. Another key result highlights that socio-demographically disadvantaged older people, particularly women, widows, and those with lower education and income levels, tend to report more negative perceptions of aging and health, along with lower ICT usefulness and critical health literacy.
DISCUSSION AND CONCLUSION: The findings underline how cumulative social disadvantages shape older adults’ aging and health perceptions. By integrating individual-level cognitive factors with broader social determinants, this study addresses a significant gap in the Turkish context. Future research should track these perceptions over time to contribute to developing comprehensive health policies.

INTRODUCTION: Electrical injuries are critical emergencies with outcomes from local damage to systemic complications. Severity depends on current type, voltage, contact duration, resistance, and current path. Predictive data from initial emergency department (ED) presentations remain limited. This study aims to identify clinical and biochemical markers at ED admission that predict adverse outcomes (intensive care unit [ICU] admission, prolonged hospitalization, complications).
METHODS: This retrospective study analyzed electrical injury cases (ICD-10: T75.4, W86, W87) in a secondary-level ED between January 2020 and January 2025. Demographics, injury details, clinical findings (mental status, burns, electrocardiography [ECG], chest X-ray), and outcomes were collected. Ethical approval was obtained. Statistical methods included chi-square, t-test, Mann–Whitney U, Kruskal–Wallis, Spearman correlation, regression, and receiver operating characteristic (ROC) analysis (p<0.05).
RESULTS: Among 142 patients, 65.5% were male, with peak incidence in ≥21 (35.9%) and ≤5 (28.9%) years. Most injuries were domestic (85.9%) from appliances (54.9%) involving alternating current (AC; 95.8%). All non-normal sinus rhythm (non-NSR) ECG patients were admitted to the ICU. Other predictors included outdoor injuries, direct current (DC) exposure, foot/head contact, falls, unconsciousness, and severe burns. Creatine kinase (CK), CK-MB, and lactate levels showed high predictive value. Lactate and hemoglobin were associated with longer hospitalization. Positive chest X-ray findings and elevated lactate were independent predictors, while appliance-related injuries were protective.
DISCUSSION AND CONCLUSION: Early ECG and laboratory assessments (lactate, hemoglobin, CK, CK-MB), along with event and burn characteristics, help predict outcomes in electrical injuries. Prompt ED risk stratification is essential.

INTRODUCTION: Planetary health, ecohealth, and environmental health have emerged as key research domains that adopt an interdisciplinary approach to global health challenges by addressing the direct and indirect impacts of environmental change on human health. The study aims to evaluate how these concepts have evolved in the academic literature between 2004 and 2024, main thematic focuses and the geographical distribution of scientific output.
METHODS: Data were obtained from the Web of Science Core Collection database, and Bibliometrix (R package) and Biblioshiny interface were used in the analysis. The 9347 publications were evaluated. Conceptual clusters and thematic transitions over time were also included in the analysis.
RESULTS: The analysis showed that there has been a significant increase in publications in the literature, especially after 2015. Five main conceptual areas were identified in the thematic analysis: (1) climate change and heat stress, (2) ecosystem health and biodiversity, (3) sustainability and resilience, (4) health systems and risk assessment, (5) zoonotic diseases and public health policies.
DISCUSSION AND CONCLUSION: The planetary health literature is gaining momentum as a critical field for in terms of global health. Our findings suggest significant implications for global health policy design, particularly for strengthening planetary health governance in underrepresented regions.

INTRODUCTION: Exocrine pancreatic function, assessed via fecal pancreatic elastase (FPE), could contribute to the pathophysiology of erectile dysfunction (ED); however, supporting evidence is limited. The present study aimed to prospectively evaluate FPE levels in men and investigate the association between exocrine pancreatic insufficiency (EPI) and erectile function.
METHODS: This prospective observational study was carried out between June and August 2025 at the urology outpatient clinic of the hospital. Male patients aged between 40 and 65 years presenting with any complaint were enrolled. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5). Stool samples were analyzed for FPE by ELISA. Group comparisons were performed using non-parametric tests, and predictors of erectile function were assessed with multivariate regression.
RESULTS: A total of 153 patients were included. Median FPE levels demonstrated nominal variation across erectile function groups (p=0.048, Kruskal–Wallis), yet no statistically significant post-hoc differences after Bonferroni correction. Multivariate regression analysis revealed that diabetes mellitus (β=−0.234, p=0.016) and hypertension (β=−0.167, p=0.040) were independent negative predictors of erectile function, whereas FPE (β=0.184, p=0.017) was a positive predictor. Other variables, including age, BMI, testosterone, and prolactin, did not significantly contribute.
DISCUSSION AND CONCLUSION: To our knowledge, this is one of the first studies to explore the link between exocrine pancreatic function and ED. Findings suggest that preserved pancreatic exocrine function may be beneficial for erectile health, while diabetes and hypertension remain major negative determinants. Exocrine pancreatic function deserves further investigation as a potential diagnostic and therapeutic target in the multifactorial management of ED.

Severe acute malnutrition (SAM) is a leading cause of child mortality, particularly in low- and middle-income regions such as Nusa Tenggara Timur (NTT), Indonesia, where prevalence and poverty rates remain high. SAM weakens the immune system and increases vulnerability to infections such as pneumonia and sepsis, forming a vicious cycle between malnutrition and disease. Effective management requires early identification and integrated treatment strategies addressing both nutritional and infectious components. This case report presents a severely malnourished infant from a rural area of NTT who developed bronchopneumonia and sepsis but exhibited unexpected early weight gain following a five-day course of ceftriaxone. The rapid clinical improvement suggests a possible role of short-term antibiotic therapy not only in controlling infection but also in enhancing early nutritional recovery. Few cases in the literature have documented such substantial early weight gain in a severely malnourished infant following antibiotic treatment alone. This observation offers a novel clinical insight into the potential metabolic benefits of infection control during the acute phase of SAM and highlights the need for further research into the broader impact of antimicrobial therapy on nutritional outcomes.

A 28-year-old primigravida presented in the third trimester with a sore throat and cervical swelling. She was initially treated for an upper respiratory tract infection. At 41 weeks, she delivered vaginally due to oligohydramnios. Her symptoms progressed during the puerperium, and imaging revealed cervical lymphadenopathy. Biopsy confirmed diffuse large B-cell lymphoma (non-germinal center phenotype). Chemotherapy was initiated, and clinical follow-up is ongoing. Immunologic changes during pregnancy may increase susceptibility to lymphoproliferative disorders, particularly Hodgkin lymphoma. However, the diagnosis of non-Hodgkin lymphoma (NHL) during pregnancy or the postpartum period is exceedingly rare and often delayed. Case reports remain valuable in increasing clinical vigilance and improving early detection. A comprehensive systemic evaluation is warranted in pregnant or postpartum patients presenting with persistent lymphadenopathy. Lymphoma should be considered in the differential diagnosis of cervical and submandibular masses during this period. Early recognition and treatment of NHL in pregnancy can significantly reduce maternal morbidity and mortality.