The Evaluation of Medical Services presented to Students of physical education and Sport Sciences College/ university of Baghdad

The research aimed at identifying the medical services present to the students of physical education and sport sciences/university of Baghdad. The researchers hypothesized significant statistical differences in medical services evaluation. They used the descriptive method on (274) forth year College of physical education and sport sciences college students, university of Baghdad for the academic year 2021 – 2022. Only (150) students’ questionnaire was used in this researcher. The questionnaire included eight axis; each axe consisted of five questions (safety and first aids, medical examination and periodical comprehensive medical test, injury treatment, healthy environment, contagious diseases control, sports nutrition, personal health, psychological care). The research came up with many conclusions and recommendations.

Graves’ Disease Induced Severe Hypercalcemia

Introduction: Hyperthyroidism is a well-known non-parathyroid hormone-mediated cause of hypercalcemia. Hypercalcemia associated with thyrotoxicosis is usually asymptomatic. Increased osteoclastogenesis is one of the mechanisms underlying this etiology. Hyperthyroidism is associated with mild to moderate levels of hypercalcemia in approximately 20% of patients, but severe hypercalcemia is rare. We report a case of a male with Grave’s disease-induced symptomatic severe hypercalcemia. Clinical Case: A 36-year-old male with type 2 diabetes mellitus and arterial hypertension who was transferred from another institution to our Emergency Department due to suspected primary hyperparathyroidism for Endocrinology Services evaluation. Family history is non-contributory. Patient reports palpitations, irritability, and unintentional weight loss of approximately fifty pounds in nine months. One month ago, he started with constipation, anxiety, depression, abdominal discomfort, nausea, and vomiting for which decided to seek medical attention. Physical examination was remarkable for tachycardia, dry mucous membranes, and goiter. Laboratory tests showed lipase 69 U/L (13-60U/L), albumin-corrected calcium 14.3 mg/dL (8.8-10.3mg/dL), phosphorus 3.30 mg/dL (2.4-4.2mg/dL), magnesium 1.58 mg/dL (1.8-2.2mg/dL), creatinine 1.38 mg/dL (0.90-1.30 mg/dL), alkaline phosphatase 77 IU/L (43-115IU/L), iPTH 4 pg/mL (11-67pg/mL), PTHrp <0.4 pmol/L (≤4.2pmol/L), 25-OH vitamin D 32.1 ng/mL (30-100ng/mL), 1,25-dihydroxyvitamin D <5.0 pg/mL(19.9-79.3pg/mL), hemoglobin 11.6 g/dL (14-18g/dL), negative serum and urine protein electrophoresis, TSH 0.003 uIU/mL (0.45-5.33 uIU/mL), free T4 2.80 ng/dL (0.71-1.85ng/dL), total T3 2.57 ng/mL (0.80-2.00ng/mL), TSI: 486% (<140%), urine calcium 24hr 525mg/day (100-300mg/day). Thoracic and abdominopelvic CT scan without contrast was unremarkable for masses, adenopathies, osseous lesions, or acute abdominal processes. Patient was treated with IV isotonic saline and methimazole 10mg oral daily with resolution of symptoms. Finally, diagnosed with Graves’ disease as the cause of hypercalcemia after ruling out other etiologies. He was discharged home with calcium levels 10.8 mg/dL, normal renal function, methimazole, and follow up with Endocrinology Services. Conclusion: This is a case of an atypical presentation of hyperthyroidism-induced symptomatic hypercalcemia. It is important to consider hyperthyroidism in the differential diagnoses of severe hypercalcemia. Prompt suspicion is essential due to the effective treatments available for Graves’ disease. Early treatment of hypercalcemia is important for quick resolution of symptoms and decreased associated mortality.

ANALISIS WAKTU TUNGGU PELAYANAN RESEP PADA PASIEN RAWAT JALAN DI RSUD DR. H. ABDUL MOELOEK PROVINSI LAMPUNG

Pharmaceutical services are health services in hospitals that are expected to meet minimum service standards (SPM) in an effort to improve the quality of services to patients. One of the pharmaceutical service categories in the minimum service standard (SPM) in hospitals is the waiting time for prescription services in the form of nonconcoction drugs is the grace period from the time the patient submits a prescription to receiving non-concoction drugs with a minimum standard set by the Ministry of Health that is ≤ 30 minutes, whereas the waiting time for prescription concoction services is the grace period from the time the patient submits the prescription until receiving the concoction drug that is ≤ 60 minutes. This research was conducted to analyze the waiting time for outpatient prescription services in Dr. H. Abdul Moeloek based on hospital minimum service standards (SPM) as an overview of prescription services, evaluation materials and pilots in an effort to improve the quality of pharmaceutical services. This research will be conducted at the pharmacy outpatients Dr. H. Abdul Moeloek in August - September 2019 with a sample of 172 recipes, consisting of 98 non-concoction recipes and 74 recipe concoctions. Based on the research that has been done, the results of waiting time for non-concoction prescription services in the Outpatient Installation of Dr. H. Abdul Moeloek is in accordance with the SPM at the Hospital with an average waiting time of 11 minutes. Waiting time for prescription concoction services in Dr. Outpatient Hospital Installation H. Abdul Moeloek is in accordance with the SPM at the Hospital with an average waiting time of 19.4 minutes. Keywords: Pharmaceutical services, waiting time, pharmaceutical service standards.

Expectations, values, preferences and experiences of Hungarian primary care population when accessing services: Evaluation of the patient’s questionnaires of the international QUALICOPC study

Background: Preferences and wishes of patients is an important indicator of primary health care provision, although there are differences between national primary care systems. Aim: The aim of this paper is to describe and evaluate the preferences and values of Hungarian primary care (PC) patients before accessing and to analyse their experiences after attending PC services. Methods: In the Hungarian arm of the European QUALICOPC Study, in 2013–2014, information was collected with questionnaires; the Patient Values contained 19 and the Patient Experiences had 41 multiple-choice questions. Findings: The questionnaires were filled by 2149 (840 men, 1309 women) using PC services, aged 49.1 (SD ± 16.7) years, 73% of them having chronic morbidities. Women preferred to be accompanied and rated their own health better. Patients in the lowest educational category and women visited their GPs more often, and they are consulted more frequently by other doctors as well. Men, older and secondary educated people reported more frequently chronic morbidities. Longer opening hours were preferred by patients with higher education. The most preferred expectations were availability and polite communication of doctors, not pressures on consultation time, clear instructions provided during consultations, shared decisions about treatments and options for consultations, the knowledge of the doctors concerning the living conditions, social and cultural backgrounds of patients, updated medical records, short waiting times, options for home visits, wide scope of professional competences and trust in the doctor. Conclusion: Wishes, preferences of patients and fulfilment were similar than described in other participating countries of the study. Although there are room to improve PC services, most of the questioned population were satisfied with the provision.

Towards Sustainability in E-Banking Website Assessment Methods

Nowadays, banking services have evolved from offline financial services to online platforms available in the form of websites and mobile applications. While multiple methods exist for evaluation of generic-purpose websites, the appraisal of banking services requires a more sophisticated approach. Multiple factors need to be taken into consideration, revolving not only around technical and usability aspects of the sites, but also considering the economic and anti-crisis factors. Moreover, due to the fact that one of the groups of people interested in banking services assessment are potential clients, which might or might not be technically and theoretically literate, a sustainable approach to banking services evaluation is needed. The main contribution of this paper is a sustainable approach balancing the evaluation accuracy with usage simplicity and computational complexity of evaluation methods. Also, a reference model for banking services evaluation is provided. In practical terms, a set of all significant commercial banking services in Poland is assessed. Last, but not least, a preliminary study of practical applicability of various evaluation methods amongst computer-literate banking clients is performed.