Open Access Macedonian Journal of Medical Sciences

The Use of Booklet and “SIGAP ANAK” Application for Education on Early Detection of Pneumonia in Children Under Five

Ely Mawaddah — 2025-12-15

BACKGROUND: Pneumonia is a leading cause of morbidity and mortality among children under the age of five around the world particularly in developing countries where access to healthcare is limited. Regular monitoring of children for symptoms is crucial for early detection of pneumonia. Education about pneumonia detection in parents and caregivers is crucial for prevention and lowering mortality rates.

METHOD: This study used a RnD (Research and Development) design, in which SIGAP ANAK application and booklet were developed as educational media for early detection of pneumonia. The population for this study consisted of mothers under the age of five at rural area and total of 120 mothers were divided into two groups and assigned randomly. Data collection was carried out using a questionnaire developed and evaluated for validity and reliability to determine the level of parental knowledge about pneumonia detection in children under five. Additionally, Wilcoxon and Mann-Whitney tests were used to analyze data.

RESULTS: The results showed that the control group average before receiving education using booklet was 16.78, while the average after education was 17.93. With the use of SIGAP ANAK application, the average knowledge before and after the intervention was 15.62 and 17.38 respectively. Based on the Wilcoxon test result, education using booklet and "SIGAP ANAK" application significantly affected knowledge about pneumonia p-value = 0.00 (p < 0.05). However, based on the Mann Whitney test result there was no difference between the intervention and control groups p-value = 0.149 (p >0.05).

CONCLUSION: The SIGAP ANAK application and booklet can be used to provide education about early detection of pneumonia for mothers with children under five in rural area.

The Booklet and Daily Food Guide Cards to Improve Responsive Feeding Practice of Mothers, on Stunted Children Aged 6-24 Months in Rural Area, West Lombok

Mira Utami Ningsih — 2025-12-15

BACKGROUND: Stunting is at high risk of occurring in the first two years of a child's life (0-24 months), and will be difficult to overcome if it continues until the child is more than 2 years old. An important determinant of complementary feeding to prevent stunting is the ability of caregivers/parents to provide food, including knowledge, attitudes and practices of feeding.

AIM: This study investigates the effectiveness of booklet and daily eating guide card in improving mothers’ feeding practice regarding responsive feeding.

METHODS: This study is an experimental research and development study (R&D) with pre-posttest design. Samples were selected using a purposive sampling technique and random sample technique.

RESULTS: Results showed differences in the level of knowledge, attitudes and practices of respondents between before and after being given education (Sig. (2-tailed): 0.000<0.05). It can be concluded that Booklet and daily eating guide card are proven to be effective in improving feeding practice of mothers of stunted toddlers.

CONCLUSION: These media can be used in education to improve knowledge, attitudes and practice of responsive feeding among mothers.

Postoperative Atrial Fibrillation after Cardiac Surgery: A Review of Risk Factors, Clinical Outcomes, and Management Strategies

Ana Marija Taseva Vasileva — 2025-12-15

Postoperative atrial fibrillation (POAF) is the most common arrhythmia following cardiac surgery and is associated with increased morbidity, prolonged hospitalization, and higher long-term risks of stroke, heart failure, and mortality. Once considered a transient and benign condition, POAF is now recognized as a clinically significant complication with lasting prognostic implications. This narrative review summarizes the current evidence on the epidemiology, risk factors, pathophysiology, clinical consequences, and management strategies of POAF. It highlights both pharmacological and non-pharmacological preventive measures, including beta-blockers, amiodarone, and posterior pericardiotomy, while also examining the ongoing controversy surrounding anticoagulation therapy in the postoperative setting. Current guideline recommendations for anticoagulation remain inconsistent, largely due to limited high-quality evidence and the absence of validated risk stratification tools tailored to surgical patients. Future research should focus on refining predictive models such as the CHA₂DS₂-VASc score and generating robust randomized data to inform treatment decisions, especially concerning anticoagulation. Recognizing POAF as a marker of long-term cardiovascular risk is essential to improving outcomes and guiding individualized postoperative care.

A Cross-Sectional Study of Maternal Sleep Quality in the First Two Years of Childcare

Sanja Gjorgjeva — 2025-12-15

BACKGROUND: The postpartum period and early years of motherhood represent a transformative stage in a woman’s life, accompanied by significant physiological, psychological, and social changes. One of the most commonly reported challenges during this period is sleep disruption. Sleep disturbances are common among mothers of young children, yet limited data exist for this issue in the context of North Macedonia. This study explores the prevalence and correlates of poor sleep quality among mothers in the postpartum period.

AIM: To assess the sleep patterns, duration, and quality among mothers with young children and identify key demographic, behavioral, and psychosocial factors associated with sleep disturbances.

METHODS: A cross-sectional survey was conducted among 648 mothers of children aged 0–2 years in North Macedonia. A structured questionnaire was used to collect data on sleep duration, sleep quality (using the Pittsburgh Sleep Quality Index), and associated factors such as maternal age, number of children, employment status, co-sleeping, and perceived stress.

RESULTS: Findings revealed that over 60% of participants reported poor sleep quality, with significant reductions in sleep duration compared to their pre-motherhood period. The most common issues were frequent night awakenings and difficulty falling back asleep. Poor sleep was significantly associated with lack of family support, chronic fatigue, and higher levels of self-reported stress.

CONCLUSION: Maternal sleep quality in North Macedonia is substantially affected during early child-rearing years. Tailored interventions focusing on maternal mental health, family support, and sleep hygiene education are needed to improve sleep health in this vulnerable population.

Applications of Artificial Intelligence in Healthcare Management: A Systematic Review of Operational Efficiency and Challenges

Ina Gjini — 2025-12-15

BACKGROUND: Artificial intelligence (AI) is increasingly applied in healthcare administration, yet systematic evidence on its impact remains scarce. While most reviews focus on clinical decision-making, the non-clinical management domain—where inefficiencies in resource allocation, workflow, and finance persist—remains understudied.

OBJECTIVE: To systematically evaluate the role of AI in optimizing healthcare management, to identify implementation barriers, and to propose governance recommendations.

METHODS: We conducted a systematic review in accordance with PRISMA guidelines. PubMed, IEEE Xplore, and Scopus were searched for peer-reviewed studies published between 2015 and 2024. Eligible studies addressed AI applications in non-clinical healthcare management. Data were extracted on AI type, application domain, and outcomes. The final inclusion comprised 80 studies.

RESULTS: AI improved operational efficiency (predictive scheduling reduced wait times by 27%), enhanced financial integrity (fraud detection saved $3.2M annually), and optimized supply chains (robotic inventory systems reduced stockouts by 19%). Barriers included ethical risks (15% of triage algorithms exhibited bias) and interoperability challenges.

CONCLUSIONS: This review identifies three major domains of impact (efficiency, finance, ethics), highlights the implementation gap, and introduces a governance checklist for equitable adoption. AI substantially enhances healthcare management operations. However, regulatory oversight, bias audits, and workforce adaptation are essential to ensure equitable and sustainable integration. Future reviews should expand cross-country analysis and empirical evaluations in low-resource settings.