Antibiotic resistance is a growing global crisis, straining healthcare systems and leaving us with limited options to combat drug-resistant bacteria. This retrospective, cross-sectional study examines the prevalence of antibiotic resistance patterns among urinary tract infections (UTIs) in Al-Shifa Hospital’s medical departments in comparison with non-medical departments using data from microbiology laboratory archives over a one-year period. From the examined urine cultures about 25% were obtained from internal medicine departments and double the number was obtained from non-medical departments. The positive rate was around 35% and about two-thirds of the samples were collected from female patients. Among all departments, Enterobacteriaceae spp. were found to be the most frequently isolated uropathogens, accounting for 80% of cases. However, resistance rates varied depending on the specific organism and antibiotic used. For instance, E. coli showed a resistance rate of only 5% against meropenem, while amoxicillin-clavulanic acid exhibited a resistance rate exceeding 95%.Importantly, the study revealed a significant disparity in resistance rates between medical and non-medical departments, specifically concerning third-generation cephalosporins. In internal medicine departments, resistance rates were alarmingly high, with cefotaxime, ceftriaxone, and ceftazidime showing resistance rates of 75%, 75% and 66.5% respectively. In contrast, non-medical departments displayed lower resistance rates, approximately 60%, 60% and 40%, respectively.In summary, this research sheds light on the escalating problem of antibiotic resistance in UTIs and emphasizes the discrepancy in resistance rates between medical and non-medical departments. Urgent efforts are required to address this issue and find effective solutions to prevent the rise of untreatable bacterial infections.

Biochemical systems are analytically investigated after encoding the properties of the dynamics, which rule the time evolution of the transition properties, using some Markov models, such as the Hierarchical Markov-State Models. The present paper is aimed at analytically writing the (finite) Markov chain originating from the considered Markov models. Within this framework, the interaction with the environment is considered, and the ergodicity of the systems obtained from numerical simulation is controlled and compared with the qualities of the Markov chain. The (von Neumann) conditions to be imposed on the Bloch equations for the biomaterial structures to be described analytically in a consistent way are governed. The formalisms of the ’heat bath’ and that of the control of the numerical errors ensure the good measure-theoretical framework and the ergodicity of the finite chain, respectively.The finite Markov chains are investigated and the analytical expressions are presented, after which the Hierarchical Markov-State-Model provides the time evolution of the transition probabilities in biochemical systems.The notion of heat bath is used to describe the interactions of the biomaterial with the environment and thus to control the uses of the projection operators in the Markovian processes where the appropriate measure is defined; the stochastic equations allow one to obtain the wanted measure from the probability spaces.The cases in which a violation of the Markov property of the process occurs, i.e. in open systems, or dissipative processes are also considered. Furthermore, in complex molecules in biological systems, these features are investigated to be possibly even more dramatic. As far as molecular processes are concerned, this occurrence is associated with the appearance of chaotic effects with certain characteristics of potential surfaces: rather than the technique of isocommittors, the method of projectors in measure spaces is used for the Nakajima-Zwanzig paradigm for the density operator; this latter method complementary compares the time-convolution-less technique.The finite Markov chains are finally proven to be ergodic after the control of the numerical errors which provide the Sinai-Markov partitions to be applied for the analysis of the measure space of the Markov chain, that is, one endowed with a Hilbert measure. The von Neumann conditions are therefore newly demonstrated to be apt to be applied to the Bloch equations for biomaterial structures after the use of the notion of heat bath, from which the measure space arises.The qualities of the Hierarchical Markov-Sate Models which bring the analytical expression of the time evolution of probabilities of biomaterials are therefore newly analytically studied.

Maternal cardiac arrests are rare but serious events where recognition and prompt initiation of resuscitation are crucial. Obesity is a common risk factor encountered in disorders of pregnancy as well as maternal cardiac arrests. Cardiac arrest algorithms should be followed with some changes to accommodate maternal and fetal health. We present a case of a 32-year-old pregnant patient who had a perimortem caesarean section due to maternal cardiac arrest.

Morality is a unique human subject. It is affected by a number of cultural factors, such as history, tradition, education, and religious beliefs. Ethics is based on two basic concepts: one is a "value" and the other is the duties "must". In the Islamic faith Health and illness as life and death are not mere facts, they include many values that must be respected. The disease, for example, is not only a medical scientific fact like other physiological phenomena. Despite the rise of secular people most of the arabs are believers and religion remains a significant force in society. Diseases and physical suffering have a big impact on the Muslim's life. It tests endurance, faith, and submission to one almighty God, who has healing powers for all patients. How staff ‘does’ good medical ethics depends on this perspective. To understand the Islamic contribution to medical ethics, five topics are discussed; first, obeying. God's commandments; second, categorising of commandments; third, the 5 guiding principles of Islamic Law (maqased); fourth, judging actions by intention and fifth, refers to a warrant belief in the divine decree and the predestination. In many Western countries multi-cultures and multi-religious textures are met including Muslim citizens and new immigrants. Medical Staff will be required at one point during their work to treat these Muslim patients; therefore, a minimum level of cultural awareness is a prerequisite for the delivery of care that is culturally sensitive. In this paper, there is the highlight of certain key teachings in Islamic medical issues and their applications. Hopefully, the insights gained will aid medical staff to better understand their Muslim patients and deliver care that pays due respect to their beliefs.Muslims in the U.S. and in Europe come from diverse backgrounds. Understanding their beliefs and observances is crucial for providing culturally competent care. In bringing any religious perspective to bear on medico-moral issues, a willingness to listen and courtesy in the debate is necessary.

The city of Santo Amaro (Bahia, Brazil) gained visibility among the scientific community due to the contamination of the Subaé River by lead and cadmium from the PLUMBUM Mineração e Metalurgia Ltda industry, on the banks of the river in 1956, which produced lead ingots The present work aimed to investigate the adsorption capacity of heavy metals (Pb and Cd) of EPS produced by bacterial species from the Subaé River, for possible future application of these biopolymers in bioremediation processes in areas impacted by the aforementioned heavy metals. Subaé river water was collected for physical-chemical analysis and bacterial isolation. It was verified that all isolated bacteria produced an expressive amount of Exopolysaccharide (EPS). Thus, the optimization of this production in different sugars (sucrose, glucose, and mannitol) and in three different pHs: 5.5; 6.5, and 7.5. All bacteria produced EPS in large quantities and the best sugar was sucrose at pH 7.5. In order to use the EPS for the bioremediation area, the adsorption test of lead and cadmium was carried out by the isolated EPS. 0.5 g of the EPS was dissolved in 50 ml of deionized water, then the solutions of metals, lead acetate, and cadmium sulfate (procedure performed separately) were incubated at 28 °C for 16 h after that period, and were centrifuged. Samples were filtered to separate the insoluble EPS and the filtrates obtained were used in the quantification of the metals by atomic absorption (FAAS- Flame Atomic Absorption Spectrometry). Bacillus spp., Bacillus cereus, Staphylococcus spp., and Serratiamarcescens, all showed tolerance to the tested metals, due to the efficiency in the adsorption capacity of the EPS, and it was possible to distinguish seven genera, Klebsiella pneumonia, Pseudomonas aeruginosa, Lysinibacillus spp. to be used in the bioremediation of environments contaminated with heavy metals.

Background: The age-dependent sporadic form of PD is characterized by the degeneration of dopaminergic (DA) neurons in the Substantia Nigra (SN), gliosis, and vascular changes. Vascular changes may contribute to the onset of the disease and exacerbate the neurodegenerative process, as some vascular changes occur before the onset of neuronal loss. To demonstrate the anti-neuroinflammatory efficacy of a new compound, a water-soluble form of dihydroquercetin (DHQ-WF), we studied the structural changes of microcirculatory vasculature, astroglial GFAP, and vascular endothelial growth factor –A (VEGF-A) mRNA expression in the SN of young and old rats after unilateral nigral treatment by lipopolysaccharide (LPS) and oral administration of DHQ-WF.Materials and methods: The experiments were performed on 18 young (8 weeks - 10 weeks old; 250 g - 320 g) and 18 old (18 months - 19 months old; 390 g - 450 g) male Vistar rats. Young and adult rats from the experimental groups were stereotactically injected with 2 μL LPS solution (LPS from Escherichia coli; 0,01 μL/mL) into one side of the SN. Control young and old rats were similarly injected with 2 μL sterile saline. Half of the animals in both the control and experimental groups (6 animals in each group) received a 2 ml solution containing DHQ-WF at a concentration of 3 mg/ml orally every day. After 8 weeks, brains were harvested and serial cryostat sections were prepared for histochemical (FITC-labeled tomato lectin), immunohistochemical (anti-GFAP Antibody, Cy3 Conjugate) staining, and real-time PCR (mRNA VEGF-A).Results: Eight weeks after LPS injection into the SN, a significant excess of areas occupied by cell bodies and processes of astroglial cells, the density of microcirculatory vessels, and mRNA VEGF-A expression was observed in old animals compared to control old animals and young LPS-treated rats.  Oral administration of DHQ-WF to LPS-treated rats resulted in a significant reduction of these parameters in old animals.Conclusion: Injection of LPS into rat SN induces neuroinflammation and vascular angiogenesis, maximally expressed in old animals.  Administration of DHQ-WF for 8 weeks significantly reduces these LPS-induced changes. DHQ-WF may be an effective treatment for reducing the effects of neuroinflammation in the aging brain.

The Democratic Republic of Congo (DRC) grapples with a critical shortage of nurses, exacerbating disparities in healthcare access and outcomes. This mini-review examines the factors impacting the nursing workforce in the DRC and presents potential solutions to strengthen it. Decades-long regional conflicts have endangered the nursing workforce, resulting in an imbalanced distribution that disproportionately favors urban areas over rural regions. Inadequate healthcare funding, compounded by mismanagement, has led to resource scarcity and inequitable distribution, further hampering nursing efforts. Additionally, stagnant policy reforms and ineffective advocacy have hindered improvements in nurse employment, wages, education, and working conditions. Infrastructure deficiencies and medical supply shortages have also contributed to reduced incentives for nursing professionals. Therefore, we undertook a mini-review aimed at offering a succinct and targeted overview of nursing care in the DRC. This involved analyzing available literature and data concerning the nursing workforce with a particular focus on the DRC. We believe that addressing these interlinked challenges necessitates comprehensive strategies that prioritize establishing regional stability, responsibly allocating and increasing healthcare funding, incentivizing nurse recruitment and retention through policy adjustments, enhancing healthcare infrastructure and nursing education, and fostering both local and global collaboration. Investing in nursing is paramount for transforming healthcare delivery in the DRC, particularly considering nurses' pivotal roles in delivering preventive, therapeutic, and palliative care services. Strengthening nursing capacity and addressing systemic challenges are essential steps toward mitigating healthcare disparities and enhancing population health, aligning with the objectives outlined in the United Nations Sustainable Development Goals.

Introduction: Acute lower respiratory infection (ALRI) of viral etiology is a frequent consultation in pediatrics. Post-infectious bronchiolitis obliterans (PIBO) is a rare and potentially severe disorder following ALRI, characterized by partial or complete obstruction of the small airways by inflammatory tissue. There is evidence that macrolides reduce morbidity and mortality in diffuse panbronchiolitis, which may have similar inflammatory and obstructive components.We hypothesized that the effect of azithromycin (AZ) may improve lung function and reduce pulmonary exacerbations in PIBO.MethodsStudy design: A double-blind, randomized, placebo-controlled trial.Patients: We enrolled patients with PIBO followed-up at the Pulmonology department between 5 years to 18 years.Treatment regimen: The patients were randomized to receive active drug or placebo three times a week. Clinical evaluation: Clinical evaluation, pulse oximetry, lung function, and 6-min walk test were performed before and after study initiation and at 1, 3, and 6 months.CT scan and a quality of life questionnaire were performed at the beginning and the end of the Study.Results: 29 patients, 15 in G1 (10 males) and 14 in G2 (7 males) were included.There were no significant differences in FVC, FEV1, TLC, RV, or sGaw between the treatment group and controls. In addition, no significant differences were observed in exacerbations, quality of life questionnaire, or HRCT scan scores.Conclusion: No differences were observed between the groups. Further studies are necessary to allow us to find a better treatment, as azithromycin does not seem to be efficacious.

The Canadian healthcare system, grappling with issues like systemic and intelligently established structural anti-black racism, including indigenous nations; even within Pathology and Laboratory Medicine Communities: and deteriorating outcomes, sees potential in AI to address challenges, though concerns exist regarding exacerbating discriminatory practices. In clinical pathology, AI demonstrates superior diagnostic accuracy compared to pathologists in a study, emphasizing its potential to improve healthcare. However, AI governance is crucial to navigating ethical, legal, and societal concerns. The Royal College of Physicians of Canada acknowledges the transformative impact of AI in healthcare but stresses the need for responsible AI tools co-developed by diverse teams. Despite positive attitudes towards AI in healthcare, concerns about patient safety, privacy, and autonomy highlight the necessity for comprehensive education, engagement, and collaboration. Legal concerns, including liability and regulation, pose challenges, emphasizing the need for a robust regulatory framework. AI application in healthcare is categorized as high-risk, demanding stringent regulation to ensure safety, efficacy, and fairness. A parallel is drawn to drug regulation processes, suggesting a similar approach for AI. The lack of transparency in AI-based decision-making raises ethical questions, necessitating measures to address biases and ensure patient privacy. Social accountability is crucial to prevent AI from exacerbating health disparities and harming marginalized communities. In conclusion, while AI offers potential benefits in clinical pathology, a cautious approach with comprehensive governance measures is essential to mitigate risks and ensure ethical AI integration into healthcare.

Essential oils (EO) are extracted from different plant species and can be present in different plant organs. Rosemary-pepper EO is composed of around 50% to 70% thymol, a phenolic compound proven to be active against fungi and bacteria. The active components present in these compounds can affect the vital functionality of bacterial cells, leading to protein denaturation and cell lysis. Therefore, the present study aims to evaluate in vitro the antibacterial potential of Lippia origanoides EO against gram-negative bacteria. This is an exploratory study, with a technical-experimental procedure, with a quantitative approach, carried out at the Federal University of Campina Grande. The strains used were Pseudomonas aeruginosa ATCC 27853, Proteus mirabilis ATCC 25933, and Escherichia coli ATCC 25922, using concentrations of 1024, 512, 256, and 128 μg/ml using the disc diffusion method in triplicate. After the incubation period, the formation of halos of bacterial growth inhibition was not observed. There are possible causes for the lack of antibacterial activity of the EO concerning the strains of gram-negative bacteria used in the study, including the possibility of not containing components with antibacterial properties in concentrations sufficient for the expected activity at the concentrations tested. Based on the results obtained, the Rosemary-Pepper EO (Lippia organoids) did not demonstrate antimicrobial activity against the gram-negative bacteria used in the study. Therefore, the development of new research with Lippia origanoides essential oil with gram-positive bacteria is suggested.

Caregivers of Children Living with HIV/AIDS experience severe burdens in Africa amidst unmet needs while seeking care from hospitals. This study aimed to explore the diagnosis history, health-seeking behaviour, and care provided by hospitals and whether the services meet caregivers’ expectations. We used a qualitative approach and conducted individual in-depth interviews among purposively sampled caregivers of children living with HIV/AIDS from three hospitals. We achieved data sufficiency after interviewing nine participants. Audio-recorded interviews were transcribed verbatim and thematically analyzed manually through Collaizi’s steps. Four themes developed including; history of pregnancy and poor HIV testing, effective care for caregivers and CLWH, attitude of healthcare providers, and unmet expectations of care. Healthcare providers showed positive attitudes towards caregivers and provided services (counselling, dispensing Anti-retrovirals, health monitoring, and coordination of clinical care). Expectations bordered on financial support (for food, education, health care), and treatment for opportunistic infections. Findings indicate gaps in HIV voluntary testing for pregnant women, enrollment in Prevention of Mother to Child Transmission (PMTCT), and unmet needs. It is imperative to improve coverage of testing for pregnant women and efforts made to meet their needs. Financial support, provision of food security, and assistance for caregivers are essential for care.

The burden of sexually transmitted infections (STIs) continues to increase with over one million curable STIs occurring daily worldwide. Sex disparity in the rates of testing for STIs can compromise the efforts to reduce the incidence of STIs. The study aimed to explore the barriers to facility-based screening for STIs among men in Ghana. A qualitative exploratory design was employed in this study. Using a semi-structured interview guide, individual in-depth interviews were conducted among purposively sampled men from November 2019 to January 2020. Data saturation was achieved at the ninth participant. Audio-recorded interviews were transcribed verbatim and analysed thematically through Braun and Clarke’s approach. Four themes emerged from the analyses: (1) lack of privacy from healthcare providers, (2) mistrust of healthcare providers, (3) the burden of handling thoughts of positive status, and (4) fear of stigmatisation. These barriers deterred men from seeking clinic-based screening for STIs. The barriers were multi-factorial and a major hindrance to ensuring that people are aware of their STI status through screening and diagnosis. It is imperative to consider these barriers when designing STI screening interventions and policies to help promote facility-based screening for STIs among men in Ghana.