The Effects of Phenytoin on Thyroid Function Tests: A Case Mimicking Central Hypothyroidism

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Introduction: Phenytoin, a widely used antiepileptic, can alter thyroid hormone metabolism and laboratory assays, potentially mimicking central hypothyroidism.

Case Presentation: A 75-year-old woman on long-term phenytoin presented with nonspecific symptoms and thyroid function tests showing low free T4 with a normal TSH. Workup revealed no evidence of pituitary disease. Elevated phenytoin levels and the absence of clinical hypothyroid features suggested phenytoin-induced assay interference or altered metabolism.

Conclusion: In patients on chronic phenytoin therapy, discordant thyroid function tests may not indicate true hypothyroidism but rather drug-induced changes. Clinical correlation is essential before initiating unnecessary treatment.

Time to Normalization of Thyroid Function Tests and Associated Factors Among Thyrotoxic Patients at Saint Paul’s Hospital Millennium Medical College Endocrine Clinic, Addis Ababa, Ethiopia, 2024

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Background: Thyrotoxicosis is characterized by excessively high tissue thyroid hormone levels. Untreated or inadequately managed thyrotoxicosis can lead to various complications. Understanding factors influencing the time to achieve thyroid function normalization is essential for improving treatment outcomes and patient care.

Objectives: This study aimed to assess the median time to normalization of thyroid function tests and identify factors associated with delayed euthyroidism among thyrotoxic patients attending the Endocrine Clinic at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, in 2023.

Methods: A hospital-based retrospective cohort study was conducted involving 181 patients diagnosed with thyrotoxicosis who attended the adult Endocrine Clinic from April 2023 to January 2024. Data were collected using a structured questionnaire and entered into EpiData version 7.1, then exported to STATA version 15 for analysis. Descriptive statistics summarized continuous variables as mean ± SD or median with interquartile range, and categorical variables as frequencies and percentages. The association between independent variables and time to euthyroidism was analyzed using Cox proportional hazards regression, with the log-rank test employed to compare median times across groups. Adjusted hazard ratios (AHR) with 95% confidence intervals (CI) were reported to quantify the strength of associations.

Results: Approximately 61% of patients achieved euthyroidism, with a median time of 7 months (Interquartile Range: 3–13 months). Factors significantly associated with delayed normalization included use of Propylthiouracil (AHR = 0.33; 95% CI: 0.12–0.89), poor medication adherence (AHR = 0.24; 95% CI: 0.13–0.42), higher baseline pulse rate (AHR = 0.97; 95% CI: 0.95–0.99), and elevated baseline free thyroxin levels (AHR = 0.99; 95% CI: 0.98–0.995).

Conclusion: Although more than half of the patients attained euthyroidism, the process took longer than expected. High baseline FT4 levels, elevated pulse rate, non-adherence to medication, and the use of PTU as the anti-thyroid drug delayed the achievement of euthyroidism. Patients with thyrotoxicosis require attentive and continuous monitoring until thyroid function normalizes to prevent complications.

The Impact of Psychological Capital and Leader-Member Exchange on Employee Productivity: A Systematic Literature Review

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Employee productivity is a key indicator in assessing the effectiveness and efficiency of individual performance in achieving organizational goals. Achieving optimal productivity is influenced by various factors, including individual psychological aspects and interpersonal relationships within the workplace, thereby requiring support from company management. This study aims to analyze the influence of psychological capital and leader-member exchange on employee productivity at Company, located in East Jakarta. This company is a multinational manufacturing company in the consumer health sector that produces various healthcare products for both domestic and international markets. The sampling in this study was conducted using a stratified random sampling technique, involving 131 respondents, consisting of both permanent and non-permanent employees directly recruited directly by the company. The research instrument utilized a questionnaire with a 5-point Likert scale, and data were collected through an online survey method. Data analysis was performed using the Structural Equation Modeling–Partial Least Squares (SEM-PLS) approach with the SmartPLS software. The results of the analysis indicate that all proposed hypotheses are supported, suggesting significant relationships among the variables. Psychological capital was found to have a positive influence on employee productivity, as did leader-member exchange. These findings offer practical implications for company management, highlighting the importance of fostering employees’ positive psychological conditions and maintaining high-quality superior-subordinate relationships to sustainably enhance productivity.

The Influence of Financial Literacy and Cashless Payment on Consumptive Behavior of Generation Z in Jakarta

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The increasing adoption of digital financial services has significantly reshaped consumption patterns, particularly among Generation Z who are native to digital environments. Despite rising national financial literacy levels, the gap between knowledge and actual financial behavior persists. This study examines the effect of financial literacy and cashless payment on the consumptive behavior of Generation Z in the DKI Jakarta region. A quantitative approach was employed with purposive sampling, involving 130 respondents. Data were collected using structured questionnaires and analyzed using multiple linear regression in SPSS. The results reveal that financial literacy has a significant negative effect on consumptive behavior, while cashless payment has a significant positive effect. Moreover, both variables jointly influence consumer behavior significantly. These findings highlight the paradox of financial awareness coexisting with increasing consumption risks due to frictionless payment systems. The study suggests that educational initiatives should not only focus on enhancing financial knowledge but also promote behavioral control when using digital financial tools.

Ventricular Septal Defect Posterior to Acute Myocardial Infarction

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We present the case of an 84-year-old woman who arrived at our unit with chest pain of cardiac origin, a Wellens type A pattern on the electrocardiogram, and on physical examination, a holosystolic murmur at the tricuspid and mitral areas radiating to the right parasternal border—a finding suggestive of ventricular septal defect. She was admitted to the Coronary Care Unit for continuous monitoring. Transthoracic echocardiography revealed rupture of the interventricular septum, along with an image compatible with a dissecting interventricular hematoma. These findings confirmed the presence of a left-to-right shunt. This case highlights the essential role of echocardiography in the early detection of mechanical complications following acute myocardial infarction, and underscores the complexity of managing post-infarction septal rupture in elderly patients.

Building Customer Loyalty in B2B Logistics: The Interplay of Trust, Perceived Risk, and Perceived Value in Indonesia’s Trucking Industry

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This research analyzes the determinants of customer loyalty in Indonesia’s B2B logistics industry, particularly in the trucking sector, focusing on trust, perceived risk, and perceived value. Adopting a quantitative approach, this study samples businesses that use trucking services and examines how the mentioned variables influence enduring customer loyalty. Using comprehensive industry theoretical models, we prepared a structured questionnaire and subsequently collected data from many firms spanning multiple industries that depended on trucking logistics. The research employs advanced statistical methods such as factor analysis and SEM to evaluate the relationships between the key constructs trust, perceived risk, perceived value, and customer loyalty. The findings underscore the role of perceived value as the foremost predictor of customer loyalty; trust only affects loyalty indirectly through its impact on perceived value. The findings suggest that perceived risk should be accepted in high choice or digitized markets, implying organizations need more emphasis on trust and its actual outcome. The study demonstrates that strategically managing perceptions of trust, risk, and value is critical for enhancing.

The Effect of Environmental Management System, Green Investment, Company Size, Profitability, and Public Accounting Firm Reputation on Carbon Emission Disclosure in Energy Sector Companies Listed on the IDX in the Period 2019-2023

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This research aims to investigate and empirically prove the impact of environmental management systems, green investment, company size, profitability, and public accounting firms’ reputations on carbon emission disclosure. The study’s population consists of companies in the energy industry listed on the IDX between 2019 and 2023. We selected the study sample using a census sampling approach that yielded 219 observations. We used the Eviews 12 software for panel data regression analysis as our data analysis method. According to the study’s findings, carbon emission disclosure is positively and significantly impacted by environmental management systems and company size but not by green investment, profitability, and public accounting firms’ reputations.

The Impact of AI on The Learning Habits of HEI Students

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The old paradigms of education are being disrupted as a result of the growing incorporation of artificial intelligence (AI) technology into higher education institutions (HEIs). The purpose of this study is to evaluate the influence that artificial intelligence-driven tools and platforms, such as adaptive learning systems, intelligent tutoring systems, automated feedback mechanisms, and AI-based content recommendation engines, have on the behaviour of students who are enrolled in higher education institutions. The research finds major changes in students’ study behaviours, time management, and learning preferences. This is accomplished via the use of a mixed-methods approach, which combines quantitative surveys and qualitative interviews with undergraduate and postgraduate students from a wide range of academic fields. The findings indicate a trend towards learning experiences that are more personalized, autonomous, and on-demand. This transition is made possible by the ability of artificial intelligence to analyse individual learning patterns and present information that is suited to those patterns. An over dependence on artificial intelligence, a decrease in critical thinking, and digital exhaustion are some of the concerns that are brought to light by the study. The final section of the study emphasises the importance of integrating artificial intelligence in a way that is balanced, so that it may improve learning outcomes while maintaining cognitive engagement and academic integrity.

The Impact of Study Habits on Academic performance: A Meta-Analysis

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This meta-analysis investigates the relationship between students’ study habits and their academic performance across a range of educational levels and cultural settings. The study synthesizes findings from fifteen empirical studies selected through a systematic review of academic databases. These studies employed various research methodologies, including quantitative, qualitative, and mixed-method designs. They examined the impact of behaviors such as time management, note-taking, goal setting, and self-testing on academic outcomes. The analysis reveals a positive association between effective study habits and academic performance. However, the strength of this relationship varies depending on factors such as educational level, cultural background, gender, learning environment, and institutional support. While many studies report a significant correlation, others show weak or non-significant results, highlighting the complexity of this relationship and the influence of contextual variables. This meta-analysis underscores the importance of integrating structured study skills training into educational programs and developing targeted interventions tailored to students’ individual needs and learning contexts. The findings contribute to a deeper understanding of how study behaviors affect academic success and offer practical implications for educators, academic advisors, and policymakers aiming to enhance student learning outcomes.

Investigation of Seasonal Fluctuations in Water Quality at Backwater Locations of Nathsagar Dam, Maharashtra

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The backwaters of Jayakwadi Dam, situated on the Godavari River in Maharashtra, constitute a critical water resource for the drought-prone Marathwada region. Known as the Nath Sagar Reservoir, this expansive water body plays a vital role in sustaining ecological balance and supporting human activities. It serves as a primary source of drinking water, irrigation, and industrial use, particularly benefiting the urban and peri-urban areas of Chhatrapati Sambhajinagar. During periods of water scarcity, the reservoir ensures water availability for both rural and urban populations, highlighting its regional importance.

This study aims to evaluate the Water Quality Index (WQI) of surface water from selected backwater stations of the Nath Sagar Reservoir to determine its suitability for domestic, agricultural, and industrial applications. Water samples were collected from multiple locations and analyzed for ten key physicochemical parameters: pH, electrical conductivity, total dissolved solids (TDS), chlorides, nitrates, sulphates, total alkalinity, total hardness, biological oxygen demand (BOD), and dissolved oxygen (DO). These indicators were selected for their significance in assessing water quality and potential environmental and health impacts.