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Objectives: With the increasing prevalence of diabetes and frailty among older adults, there is an urgent need for precision medicine that incorporates comprehensive geriatric assessments, including frailty detection. This scoping review aims to map and synthesize the available evidence on validated tools for detecting pre-frailty and frailty in community-dwelling elderly individuals with diabetes and outpatient diabetes patients. Specifically, it addresses: (1) What validated tools are available for detecting pre-frailty and frailty in this population? (2) How are these tools associated with outcomes such as glycemic control, hypoglycemia, and metabolic phenotypes? (3) What gaps exist in the literature regarding these tools? Methods: The review followed PRISMA-ScR guidelines, conducting a systematic search across PubMed, Cochrane Library, and Web of Science. The inclusion criteria focused on studies involving individuals aged 70 years and older with diabetes, emphasizing tools with predictive capacity for disability and mortality. Results: Eight instruments met the inclusion criteria, including the Frailty Index, Physical Frailty Phenotype, and Clinical Frailty Scale. These tools varied in domains such as physical, psychological, and social aspects of frailty and their association with glycemic control, hypoglycemia, and metabolic phenotypes. The review identified significant gaps in predicting diabetes-related complications and their clinical application. Conclusions: Routine management of older adults with diabetes should incorporate frailty detection, as it is crucial for their overall health. Although widely used, the reviewed tools require refinement to address the unique characteristics of this population. Developing tailored instruments will enhance precision medicine, leading to more effective, individualized interventions for elderly individuals with diabetes. [ABSTRACT FROM AUTHOR]

Objective: To determine the etiology, risk factors and antibiotic resistance in neonatal sepsis. Study Design: Cross-sectional study. Setting: Department of Pediatric Medicine, National Institute of Child Health, Karachi, Pakistan. Period: October 2023 to March 2024. Methods: A total of 174 neonates of both genders, with suspected neonatal sepsis were analyzed. Neonatal and maternal characteristics were noted. Blood sample was collected in aseptic environment and sent to institutional laboratory for blood culture and drug susceptibility testing. Results: In a total of 174 neonates, 101 (58.0%) were boys. The mean age, and weight were 9.61±7.86 years, and 2.25±0.85 kg, respectively. Neonatal sepsis on the basis of positive blood culture was reported in 38 (21.8%) neonates. Preterm birth had significant association with neonatal sepsis (44.7% vs. 26.5%, p=0.019). History of maternal UTI during pregnancy had significant linkage with neonatal sepsis (36.8% vs. 11.0%, p<0.001). History of maternal fever during pregnancy had statistically significant association with neonatal sepsis (34.2% vs/ 19.1%, p=0.049). E. Coli, and Klebsiella were the most commonly found bacterial isolates, noted in 8 (21.1%), and 4 (10.5%) neonates, respectively. Most commonly used antimicrobial drugs were found to have high resistance rates against most frequent bacterial isolates. Conclusion: E. Coli, and Klebsiella were the most commonly found bacterial isolates in neonatal sepsis. Preterm birth, maternal history of UTI, and maternal history of fever were found to be significant factors linked to neonatal sepsis. Most commonly used antimicrobial drugs were found to have high resistance patterns which should raise alarms. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the behavior of anisotropic compact stars in generalized modified gravity, namely f (R , ϕ , X) gravity, where R represents the Ricci scalar, ϕ is the scalar potential function and X is a kinetic term of ϕ. We consider the spherically symmetric spacetime to analyze the feasible exposure of compact stars. We observe the behavior of anisotropic compact stars which includes Her X1, SAX J 1808.4-3658 and 4U 1820-30. From the graphical evaluation of energy density, tangential pressure, radial pressure, equilibrium conditions, energy conditions, mass–radius relationship, compactness and stability analysis of compact stars, it is concluded that the behavior of candidates of compact stars is regular in f (R , ϕ , X) gravity for the considered parameter. [ABSTRACT FROM AUTHOR]

We discuss spherically symmetric dynamical systems in the framework of a general model of f (R) gravity, i.e. f (R) = R e ζ R , where ζ is a dimensional quantity in squared length units [L 2 ]. We initially assume that the internal structure of such systems is governed by the Krori–Barua ansatz, alongside the presence of fluid anisotropy. By employing astrophysical observations obtained from the pulsar SAX J1748.9-2021, derived from bursting X-ray binaries located within globular clusters, we determine that ζ is approximately equal to ± 5 km 2 . In particular, the model is capable of producing stable configurations for SAX J1748.9-2021, encompassing both its geometric and physical characteristics. We show that, within the framework of f (R) gravity, the Krori–Barua ansatz establishes semi-analytical connections between the radial ( p r ) and tangential ( p t ) pressures, and the density (ρ ). These relations are described as p r ≈ v r 2 (ρ - ρ I) and p t ≈ v t 2 (ρ - ρ II) . In this context, v r and v t denote the sound speeds in the radial and tangential directions, respectively. Meanwhile, ρ I pertains to the surface density, and ρ II is derived from the model parameters. These connections are consistent with the equations of state derived from the best-fit solutions identified in the ongoing investigation. Notably, within the framework of f (R) gravity where ζ is negative, the maximum compactness, denoted as C, is inherently limited to values that do not exceed the Buchdahl limit. This contrasts with general relativity or f (R) gravity with ζ positive, where the compactness has the potential to asymptotically reach the black hole threshold ( C → 1 ). The model predictions suggest a central density that largely exceeds the saturation nuclear density, which is ρ nuc = 3 × 10 14 g/cm 3 . Also the surface density ρ I surpasses ρ nuc . We obtain a mass-radius diagram, corresponding to the boundary density, which is consistent with other observational data. [ABSTRACT FROM AUTHOR]

Background. Although neonatal sepsis is a major public health problem contributing to 30-50% of neonatal deaths in low- and middle-income countries, data on predictors of time to death are limited in Eastern Ethiopia. This study is aimed at determining predictors of time to death among neonates with sepsis admitted in public hospitals in Eastern Ethiopia. Methods. An institutional-based retrospective cohort study was conducted among 415 neonates admitted to referral hospitals in Eastern Ethiopia with sepsis from January 1, 2021, to December 31, 2021. Data were collected from medical records by using structured checklist and entered using EpiData 3.1 and analyzed using Stata 17. The Kaplan-Meier curves and log-rank tests were used to describe survival experience among different categories. The proportional hazard assumption and goodness of fit for the Cox regression model were checked. The Cox regression model was used to identify the significant predictors. Hazard ratios (HRs) with 95% confidence intervals (CI) were calculated. Finally, statistical significance was set at a p value < 0.05 in the Cox regression analysis. Results. Of the 415 neonates with neonatal sepsis, 71 (17.1%) (95% CI: 13.60-21.08) died at discharge, with a median time to death of 14 days. The overall incidence rate of mortality was 36.5 per 1000 neonate days. Low birthweight (AHR = 2.50 ; 95% CI: 1.15-5.44), maternal age ≥ 35 years (AHR = 3.17 ; 95% CI: 1.11, 9.04), low fifth-minute Apgar score (AHR: 2.32; 95% CI: 1.30-4.14), and late initiation of breastfeeding (AHR = 4.82 ; 95% CI: 1.40-16.65) were independent predictors of mortality among neonates with sepsis. Conclusions. Almost one in five neonates with sepsis died at discharge. Low birthweight, maternal age ≥ 35 years, low fifth-minute Apgar score, and late initiation of breastfeeding were predictors of mortality. [ABSTRACT FROM AUTHOR]

Introduction: Growing antimicrobial resistance (AMR) and decreasing efficacy of the available antimicrobials have become a significant public health concern. The antimicrobial stewardship program (ASP) ensures the appropriate use of antimicrobials and mitigates resistance prevalence through various interventions. One of the core components of the ASP is to educate healthcare workers (HWs). Therefore, this study aims to identify the impact of a pharmacist-led educational intervention targeting knowledge, attitude, and practices regarding rational antibiotic use among healthcare professionals in a secondary care hospital in Punjab. Methods: This is a single-center, questionnaire-based, pre-post interventional study conducted over a six-month time period. Data analysis was conducted using SPSS version 26. Results: Regarding the pre-interventional knowledge, attitude, and practice (KAP) score of the respondents, 90.3% had a good knowledge score, 81.5% had a positive attitude, and 72.3% of HWs (excluding doctors) had a good practice score. Additionally, 74.6% of the doctors had a good practice score. After educational intervention, there was a significant improvement in the knowledge, attitude, and practice of the respondent HWs (p-value <0.001). Furthermore, males have higher knowledge scores compared to females in the pre- and post-intervention stages (p-value <0.05), and doctors differ from nurses regarding knowledge scores in both pre- and post-intervention stages. Conclusion: Considering educational programs as the backbone of the ASP, it is imperative to sustain efforts in the ongoing educational programs of HWs to foster high awareness and adherence to the ASP among HWs. [ABSTRACT FROM AUTHOR]

Introduction: One of the main causes of illness, mortality, and rising medical costs is antimicrobial resistance, which is a global healthcare concern. Objectives: This study explores the practice of physicians toward the effective implementation of Antibiotic Stewardship Programs (ASPs) in Najran city, Saudi Arabia. Methodology: This cross-sectional study was conducted among physicians working at primary care setting in Najran city, Saudi Arabia, between May and August 2023. A self-administered questionnaire was distributed among the physicians composed of three parts: socio-demographic data, a questionnaire about physicians' practice in the efficacy of ASP, and a questionnaire about physicians' practice regarding prescribing antibiotics. Results: Of the 128 physicians who participated in the study, 60.2% were males, and 43.8% were aged between 36 and 45 years. Among the practices in implementing the ASP effectively, controlling the source of infection domain received the highest score (mean score: 4.83). Every practice domain mean score was greater than 3, indicating that study participants possessed a moderate level of ASP practice and implementation skills. The overall mean practice score in the effective implementation of ASP was 154.9 ± 25.5 out of 185 points, with good, moderate, and poor practices constituting 67.2%, 28.1%, and 4.7%, respectively. Conclusions: The physicians showed a moderate level of practice for the effective implementation of ASPs in Najran city. The factors significantly associated with increased practice score include older age, male gender, Saudi nationality, handling five or fewer infection cases daily, and infection-initiated antibiotic prescribing treatment managed per day. These findings suggest the need for targeted interventions and educational programs to enhance physicians' adherence to ASP guidelines and promote appropriate antibiotic prescribing practices, ultimately contributing to global efforts in combating antimicrobial resistance and improving patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: to mention the importance of the bioactive compounds and fatty acids (FA) present in lychee, in addition to their possible applications Lychee is a fruit originally from Asia, which has sweet pulp and juice, presents an attractive appearance and pleasant flavor, in addition to high nutritional value, so that it is quite accepted by consumers. Lychee is a great source of bioactive compounds such as tannins and vitamin B1. Because of its functionality, it has various uses as in the preparation of teas and medicinal remedies. Because of the functionality it has, it is important to research this fruit in detail and to find possible applications. Therefore, the objective of this study. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial stewardship programs (ASPs) are pivotal components of the World Health Organization's Global Action Plan to combat antimicrobial resistance (AMR). ASPs advocate rational antibiotic usage to enhance patient-centered outcomes. However, existing evidence on ASPs and their determinants is largely limited to well-equipped hospitals in high-income nations. Objective: This scoping review aimed to examine the current state of hospital-based ASPs in low- and middle-income countries (LMICs), shedding light on barriers, facilitators, prescribers' perceptions and practices, and the impact of ASP interventions. Design: Scoping review on ASP. Methods: Adhering to PRISMA guidelines, we conducted electronic database searches on PubMed, Scopus, and Google Scholar, covering ASP articles published between January 2015 and October 2023. Our review focused on four key domains: barriers to ASP implementation, facilitators for establishing ASP, ASP perceptions and practices of prescribers, and the impact of ASP interventions. Three reviewers separately retrieved relevant data from the included citations using EndNote 21.0. Results: Among the 7016 articles searched, 84 met the inclusion criteria, representing 34 LMICs. Notably, 58% (49/84) of these studies were published after 2020. Barriers to ASP implementation, including human-resources shortage, lack of microbiology laboratory support, absence of leadership, and limited governmental support, were reported by 26% (22/84) of the studies. Facilitators for hospital ASP implementation identified in five publications included the availability of antibiotic guidelines, ASP protocol, dedicated multidisciplinary ASP committee, and prompt laboratory support. The majority of the research (63%, 53/84) explored the impacts of ASP intervention on clinical, microbiological, and economic aspects. Key outcomes included increased antibiotic prescription appropriateness, reduced antimicrobial consumption, shorter hospital stays, decreased mortality rate, and reduced antibiotic therapy cost. Conclusions: The published data underscores the imperative need for widespread antimicrobial stewardship in LMIC hospital settings. Substantial ASP success can be achieved through increasing human resources, context-specific interventions, the development of accessible antibiotic usage guidelines, and heightened awareness via training and education. [ABSTRACT FROM AUTHOR]

Objective: To assess the knowledge and skills of prescription writing among dental house officers from different hospitals. Methods: This cross-sectional study was conducted from July to September, 2022. A self-administered, structured questionnaire was used to collect data from 180 house officers from four teaching dental hospitals (n=45 each). The participants were asked to write a prescription for an adult and a pediatric patient. The prescription was evaluated according to WHO criteria. Analysis was done using SPSS v.20. Data was presented as frequencies and percentages. Results: Among the 180 participants, 42.9% were males and 57.1% were females. 33.9% participants reported prescription writing to be a difficult task. Only 36.7% participants reported to be trained in prescribing pediatric medications. None of the prescriptions completely fulfilled the WHO criteria. Doctor related information (name, address and contact no) was written by only 3.8% of the participants while 10% of the participants mentioned the patient related information (name, address and age). Dosage of the prescribed drugs was the most commonly drug-related missing parameter which was mentioned in 30% of the pediatric prescriptions and 21% of the adult prescriptions. Conclusion: There is a general lack of knowledge among the dental house officers regarding prescription writing as they were found to be unaware of the essential elements of a prescription. The findings call for an urgent change in the undergraduate teaching of prescription writing skills with special emphasis on pediatric drugs and dosage. [ABSTRACT FROM AUTHOR]

Background: Enterococcal bacteremia has become prevalent in the recent decade, especially in hospitalized patients. Moreover, the rise in resistance patterns against antibiotic drugs regarding enterococci infection, such as cephalosporins, ampicillin and vancomycin, is prevailing. The major driving force behind this is the incongruous use of antibiotics with a minor contribution from environmental stressors which calls for vigilant and prudent administration of evidence-based antibiotics. Methods: A retrospective study was conducted from January 1 2017 until December 31 2021, at the tertiary care center, Dr Ziauddin Hospital in Karachi, Pakistan. Results: Our research revealed ampicillin resistance in 87 (63.5%), with an estimated 25 (18.8%) mortality. Male gender 19 (76%) and vancomycin resistance 13 (52%) were associated with increased mortality. Furthermore, appropriate antibiotic therapy reduced the risk of death compared with inappropriate and excessive use of antibiotics 10 (40%) vs. 15 (60%) vs. 20 (80%) respectively. Targeted therapy with amoxicillin/clavulanic acid was associated with lower mortality 1 (4%) and higher discharge rates 34 (32.1%). On Kaplan-Meier survival, targeted therapy with amoxicillin/clavulanic acid was associated with shorter hospital stays and prolonged survival. UTI was found as the most common source of enterococcal bacteremia 57 (41.6%), followed by respiratory 21 (15.3%) and intra-abdominal 13 (9.5%). In 26 (19%) patients, no identifiable source of infection was found. Conclusion: Vancomycin resistance and male gender were found independent risk factors for mortality. The use of inappropriate antibiotics significantly increases mortality in these patients. The appropriate antibiotic therapy reduces the risk of death. Furthermore, overuse of antibiotics didn't reduce mortality; instead increased the financial burden and chances of developing multi-drug resistant strains of other organisms by increasing hospital stays of patients. [ABSTRACT FROM AUTHOR]

This paper investigates the wormhole solutions in Rastall theory of gravity using the Karmarkar conditions. For this purpose, we choose a shape function (SF) that connects two asymptotically flat regions. We also discuss the wormhole configuration by plotting three-dimensional (3D) analysis of the embedding diagram in Euclidean space. Furthermore, we also observe the detailed graphical representation of energy conditions using the considered SF. The violation of energy conditions, especially null energy conditions (NEC), indicates the existence of exotic matter and wormholes. Hence, it can be concluded that our calculated results in the background of Rastall theory of gravity are viable and stable. The exciting feature of this work is the 3D analysis to discuss the viability of wormhole geometry [ABSTRACT FROM AUTHOR]

Background and Objectives: The increase in antimicrobial resistance (AMR) across countries has seriously impacted the effective management of infectious diseases, with subsequent impact on morbidity, mortality and costs. This includes Pakistan. Antimicrobial surveillance activities should be mandatory to continually assess the extent of multidrug-resistant bacteria and the implications for future empiric prescribing. The objective of this retrospective observational study was to monitor the susceptibility pattern of microbes in Pakistan. Materials and Methods: Clinical samples from seven laboratories in Punjab, Pakistan were collected between January 2018 and April 2019, with Punjab being the most populous province in Pakistan. The isolates were identified and their antimicrobial susceptibility was tested using the Kirby-Bauer disc diffusion assay and micro broth dilution methods. The antibiotics assessed were those typically prescribed in Pakistan. Results: In total, 2523 bacterial cultural reports were studied. The most frequently isolated pathogens were Staphylococcus aureus (866, 34.3%), followed by Escherichia coli (814, 32.2%), Pseudomonas aeruginosa (454, 18.0%) and Klebsiella pneumoniae (269, 10.7%). Most pathogens were isolated from pus (1464, 58.0%), followed by urine (718, 28.5%), blood (164, 6.5%) and sputum (81, 3.2%). Conclusions: The findings suggest that current antimicrobial options are severally restricted in Pakistan due to the emergence of multidrug-resistant pathogens. This calls for urgent actions including initiating antimicrobial stewardship programs to enhance prudent prescribing of antibiotics. This includes agreeing on appropriate empiric therapy as part of agreed guidelines, in line with the WHO EML and AWaRe book, whilst awaiting culture reports. This is alongside other measures to reduce inappropriate antimicrobial prescribing and reverse the threat of rising AMR. [ABSTRACT FROM AUTHOR]

Background: It was in 1995 when a strategy was devised to reduce under-five mortality in countries with a prevalence of child mortality above 40/1000 live births. This strategy is called "Integrated Management of Childhood Illness" (IMCI). Improvement in the skills of healthcare workers (HCWs) depends on the IMCI training received by them. To make IMCI training more effective and scale up, a global technical consultation committee in Geneva recommended implementing an innovative training approach in 2014: the distance learning IMCI (dIMCI). This study was conducted to observe qualitatively the practices of IMCI-trained HCWs at their respective workplaces. Methods: This qualitative hermeneutic study was conducted through non-probability criterion sampling in the district Abbottabad of Pakistan on all 26 basic health units trained in IMCI (either standard or distance learning) from December 9, 2019, to March 9, 2020. Data collection was done by qualitatively observing consultations and interactions of caretakers of under-five children at basic health units. Inductive thematic analysis was used. This qualitative exploration was underpinned by Hans Georg Gadamer's philosophy of hermeneutics. Results: Four themes emerged from the observation notes. These themes are gratification after consultation, altercation for medication, non-observance of protocol, and methodical consultation. Conclusion: Improvement in the skills of HCWs in the form of IMCI training, either through distance learning or the common eleven-day standard method, can improve caretakers' satisfaction. However, awareness at the community level is needed for better compliance. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a silent pandemic that has claimed millions of lives, and resulted in long-term disabilities, limited treatment options, and high economic costs associated with the healthcare burden. Given the rising prevalence of AMR, which is expected to pose a challenge to current empirical antibiotic treatment strategies, we sought to summarize the available data on knowledge, attitudes, and practices regarding AMR in Ethiopia. Articles were searched in international electronic databases. Microsoft Excel spreadsheet and STATA software version 16 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 checklist was followed. The methodological quality of the studies included was assessed by the Joana Briggs Institute critical appraisal checklists. The random-effect meta-analysis model was used to estimate Der Simonian-Laird's pooled effect. Statistical heterogeneity of the meta-analysis was checked through Higgins and Thompson's I2 statistics and Cochran's Q test. Publication bias was investigated by funnel plots, and the regression-based test of Egger for small study effects with a P value < 0.05 was considered to indicate potential reporting bias. In addition, sensitivity and subgroup meta-analyses were performed. Fourteen studies with a total of 4476 participants met the inclusion criteria. Overall, the pooled prevalence of good AMR knowledge was 51.53% [(95% confidence interval (CI): 37.85, 65.21), I2 = 99.0%, P <0.001]. The pooled prevalence of favorable attitudes and good practices were 63.43% [(95% CI: 42.66, 84.20), I2 = 99.6, P <0.001], and 48.85% [(95% CI: 38.68, 59.01), I2 = 93.1, P <0.001] respectively. In conclusion, there is a significant knowledge and practice gap on AMR among the general public, patients, and livestock producers. As a result, we call for greater educational interventions to raise awareness and build a strong national AMR narrative. [ABSTRACT FROM AUTHOR]

Objective: To determine the burden of early onset of sepsis (EOS) in suspected neonates and to assess the most common causative agents of EOS in these neonates. Methods: This prospective cross-sectional study was conducted at H.H. Sheikh Khalifa Bin Zayed Al Nahyan Hospital/Combined Military Hospital, Muzaffarabad, Pakistan from January 2020 to June 2021. All neonates admitted in Neonatal Intensive Care Unit (NICU) during first 3 days of life with suspicion of sepsis, based on maternal history or neonatal clinical examination were enrolled. EOS was defined based on the presence of clinical sepsis developed within 72 hours of life or if positive blood/cerebrospinal fluid (CSF) cultures were detected. This information along with the bacteria causing EOS was noted. Results: Of 109 suspected neonates for EOS, positive blood culture for EOS was observed in 26 (23.9%) neonates. Risk of EOS was 7 times higher among neonates with total leucocyte count (TLC) =30,000 per mm as compared to neonates with < 30,000 per mm of TLC (aOR 7.19, 95% CI 2.12 to 24.31, p-value 0.002). Gram positive was the most common bacterial isolates, i.e., 15 (57.69%) whereas gram negative was observed in 11 (42.31%) neonates. Of 15 neonates with gram positive bacteria, all had staphylococcus aureus, i.e., 15 (100%) whereas of 11 neonates with gram negative bacteria, Escherichia coli was observed in majority of the neonates, i.e., 7 (63.64%). Conclusion: In our study cohort, a significant occurrence of EOS we observed. Specifically, gram-positive organism (staphylococcus aureus) was the predominant cause of sepsis. [ABSTRACT FROM AUTHOR]

Background and Objectives: Overprescribing of antibiotics is one of the important contributors of antimicrobial resistance globally. A high proportion of antibiotics prescribed in community settings are unnecessary or inappropriate. This study assesses the prescribing practices and factors related to antibiotic prescribing in community pharmacies in United Arab Emirates (UAE). Materials and Methods: A cross-sectional study utilizing a quantitative approach was carried out in the community pharmacies of Ras Al Khaimah (RAK), UAE. Six hundred and thirty prescription encounters from 21 randomly selected community pharmacies were investigated using World Health Organization (WHO) core prescribing indicators. Factors related to antibiotic prescribing were identified using logistic regression analyses. Results: In 630 prescription encounters, a total of 1814 drugs were prescribed. Out of these, the most commonly prescribed drug class was antibiotics (43.8% prescriptions) and the antibiotic was amoxicillin/clavulanic-acid (22.4%). The average number of drugs per prescription was 2.88, which was higher than the WHO recommended value of 1.6–1.8. In addition, more than half of the prescriptions (58.6%) had drugs by generic names and the majority of the drugs prescribed (83.8%) were from the essential drug list, which were lower than the optimal values of 100%. The majority of the antibiotics prescribed in the study were from the WHO's Access group antibiotics. Multivariable logistic regression analysis identified patient age (children—OR: 7.40, 95% CI: 2.32–23.62, p = 0.001 and adolescent—OR: 5.86, 95% CI: 1.57–21.86, p = 0.008), prescriber qualification as general practitioner (OR: 1.84, 95% CI:1.30–2.60, p = 0.001), and number of drugs per prescription (OR: 3.51, 95% CI: 1.98–6.21, p < 0.001) as independent factors associated with antibiotic prescribing. Conclusions: This study reveals considerable variations from the WHO recommendations for the different prescribing indicators in the community pharmacies of RAK, UAE. In addition, the study reports overprescribing of antibiotics in the community setting, indicating the need for interventions to promote rational use of antibiotics in a community setting. [ABSTRACT FROM AUTHOR]

The preterm infant microbiota is dominated by Enterobacteriaceae (Escherichia, Klebsiella or Enterobacter spp.), Enterococcus and Staphylococcus spp. Recent work has demonstrated the development of this microbiota is predictable and driven by simple microbe-microbe interactions. Because of their systemic immaturity, including an underdeveloped immune system, preterm infants are susceptible to a range of infections. Numerous retrospective studies have examined the association of the preterm gut microbiota with diseases such as necrotizing enterocolitis (NEC), early-onset sepsis and late-onset sepsis. To date, no single bacterium has been associated with infection in these infants, but a Klebsiella/Enterococcus-dominated faecal microbiota is associated with an increased risk of developing NEC. Staphylococci aid and enterococci inhibit establishment/maintenance of gastrointestinal Klebsiella populations in preterm infants, though the mechanisms underlying these interactions are poorly understood. Klebsiella spp. recovered from healthy and sick preterm infants display similar antimicrobial resistance and virulence profiles, giving no clues as to why some infants develop potentially life-threatening diseases while others do not. The identification of cytotoxin-producing Klebsiella oxytoca sensu lato in the gut microbiota of some preterm infants has led to the suggestion that these bacteria may contribute to NEC in a subset of neonates. This mini review highlights current knowledge on Klebsiella spp. contributing to the preterm gut microbiota and provides insights into areas of research that warrant further attention. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the anisotropic matter distribution concerning one of the well-known f (R , T) theories of gravity, where R and T represent the Ricci scalar and trace of the energy–momentum tensor, respectively. We consider anisotropic matter distribution in spherically symmetric spacetime for our desired work. We investigate the physical behavior of pressure components, energy density, anisotropic function, equation of state parameters, and energy conditions. Furthermore, we analyze the stability of compact stars by investigating the causality condition, adiabatic index, and generalized Tolman–Oppenheimer–Volkoff equation. Some fundamental features of compact stars have been investigated, like compactness factor, mass function, and surface redshift. Our calculated solutions for Bardeen stellar structures are consistent and stable in the background of the f (R , T) theory of gravity. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a leading public health threat, which is exacerbated by the high and inappropriate use of antibiotics. Consequently, there is a need to evaluate knowledge regarding antibiotic use, AMR and the readiness to implement antimicrobial stewardship programs (ASPs) among final year medical, pharmacy and nursing students in Pakistan. This reflects the high and increasing rates of AMR in the country, and students as future healthcare professionals (HCPs). A cross-sectional study was conducted among 1251 final year students from 23 public and private educational institutions in Punjab. The majority of the surveyed participants possessed good knowledge of antibiotic use, AMR and the potential causes of AMR. The most common sources of the information on antibiotics were smartphones (69.9%), peers (35.9%) and medical textbooks (30.6%). However, most surveyed participants were not fully prepared to participate in ASPs. They knew, though, how to reduce AMR by educating HCPs about appropriate prescribing, implementing ASPs and improving laboratory facilities. There was a significant association between antibiotic knowledge and causes of AMR with sex, family income and student type (p < 0.05). Being a student at a public sector university (OR = 4.809; CI = 3.261–7.094; p < 0.001) and age (OR = 0.524, CI = 0.327–0.842; p < 0.008) were among the key factors impacting students' training on ASPs. Educational curricula must be improved to include more information about appropriate antibiotic use and ASPs, along with sufficient training, workshops and clinical rotations in the final year, to fully equip students by graduation. [ABSTRACT FROM AUTHOR]

This work aims to investigate the behaviour of compact stars in the background of f(R,T)$f(R, T)$ theory of gravity. For current work, we consider the Krori‐Barua metric potential i.e., ν(r)=Br2+C$\nu (r)= Br^2+C$ and λ(r)=Ar2$\lambda (r)= Ar^2$, where, A,B$A, B$ and C are constants. We use matching conditions of spherically symmetric space‐time with Schwarzschild solution as an exterior geometry and examine the physical behaviour of stellar structure by assuming the exponential type f(R,T)$f(R, T)$ gravity model. In the present analysis, we discuss the graphical behaviour of energy density, radial pressure, tangential pressure, equation of state parameters, anisotropy and stability analysis respectively. Furthermore, an equilibrium condition can be visualized through the modified Tolman‐Oppenheimer‐Volkov equation. Some extra features of compact stars i.e. mass‐radius function, compactness factor and surface redshift have also been investigated. Conclusively, all the results in current study validate the existence of compact stars under exponential f(R,T)$f(R, T)$ gravity model. This work aims to investigate the behaviour of compact stars in the background of f (R, T) theory of gravity. For current work, the authors consider the Krori‐Barua metric potential i.e., ν(r) = Br2 + C and λ(r) = Ar2, where, A, B and C are constants. They use matching conditions of spherically symmetric space‐time with Schwarzschild solution as an exterior geometry and examine the physical behaviour of stellar structure by assuming the exponential type f (R, T) gravity model. The investigation presented here contains both a discussion of the graphical behaviour of energy density, the radial and tangential pressure, the equation of state parameters, anisotropy and and a stability analysis respectively. Furthermore, an equilibrium condition can be visualized through the modified Tolman‐Oppenheimer‐Volkov equation. Some extra features of compact stars i.e. mass‐radius function, compactness factor and surface redshift have also been investigated. Conclusively, all the results in current study validate the existence of compact stars under exponential f (R, T) gravity model. [ABSTRACT FROM AUTHOR]

Healthcare-associated infections (HAIs) have a considerable impact on morbidity, mortality and costs. The COVID-19 pandemic resulted in an appreciable number of hospitalized patients being admitted to intensive care units (ICUs) globally with a greater risk of HAIs. Consequently, there is a need to evaluate predictors and outcomes of HAIs among COVID-19 patients admitted to ICUs. A retrospective study of patients with COVID-19 admitted to ICUs of three tertiary care hospitals in the Punjab province over a five-month period in 2021 was undertaken to ascertain predictors and outcomes of HAIs. Of the 4534 hospitalized COVID-19 patients, 678 were admitted to ICUs, of which 636 patients fulfilled the inclusion criteria. Overall, 67 HAIs were identified among the admitted patients. Ventilator-associated lower respiratory tract infections and catheter-related urinary tract infections were the most frequent HAIs. A significantly higher number of patients who developed HAIs were on anticoagulants (p = 0.003), antithrombotic agents (p < 0.001), antivirals (p < 0.001) and IL-6 inhibiting agents (p < 0.001). Secondary infections were significantly higher in patients who were on invasive mechanical ventilation (p < 0.001), had central venous access (p = 0.023), and urinary catheters (p < 0.001). The mortality rate was significantly higher in those with secondary infections (25.8% vs. 1.2%, p < 0.001). Our study concluded that COVID-19 patients admitted to ICUs have a high prevalence of HAIs associated with greater mortality. Key factors need to be addressed to reduce HAIs. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a major public health problem globally, and Ghana is no exception. Good knowledge regarding antibiotic use, AMR, and the concept of antimicrobial stewardship (AMS) is critical among healthcare students to curb rising AMR rates in the future. Consequently, a need to ascertain this. A cross-sectional survey was undertaken among fifth-year pharmacy, medical students and fourth (final)-year nursing and physician assistantship students at the University of Health and Allied Sciences in Ghana to assess their knowledge on antibiotic use, AMR and AMS using a web-based self-administered structured questionnaire. Descriptive statistics, Fishers' exact test, and multiple logistic regression analyses were performed. A total of 160 healthcare students were interviewed, of which 56.3% (n = 90) were male and 58.8% (n = 94) were in their fourth year of study. Good knowledge of antibiotic use, AMR, and AMS was associated with the study course (p = 0.001) and the number of years of study (p < 0.001). Overall, there were differences in the level of knowledge of antibiotics among the different healthcare students and their years of study. Efforts must now be made to enhance the curricula to ensure an improved and uniform transfer of knowledge of antibiotics, AMR, and AMS among the different healthcare students to sustain the fight against AMR in Ghana given growing concerns. [ABSTRACT FROM AUTHOR]

Introduction: Sepsis is common among neonates, and is often fatal. Hospitalization results in severe nosocomial infections which could be resistant to antibiotics. It also incurs higher fees for medical care. Methods: A retrospective follow-up study, which includes 206 neonates, was conducted to assess the length of hospital stay among neonatal sepsis patients from September 2018 to September 2020 at TASH Hospital, Addis Ababa, Ethiopia. Data were collected from medical charts. Mean length of hospital stay was compared using independent sample t-tests. Risk factors for length of stay were identified using binary logistic regression analysis. Results: All neonates stayed a total of 325 days, which gives 75,512 neonate-days. Neonates who stayed more than 7 days had low mean birth weight and higher mean age at admission. Mean length of stay was higher among neonates with comorbid illness, neonates with drug therapy problems and male neonates. Even though the mean length of stay is shorter among neonates with maternal PROM and CS delivery, these maternal factors were found to be insignificant in the multivariate logistic regression. Discussion: Similar to other studies, neonates with low birth weight and comorbidity had a longer hospital stay. Neonates with maternal PROM and CS delivery had a shorter stay. But these maternal factors, identified by prior studies as risk factors for neonatal sepsis and its mortality, are not found to be predictors of prolonged hospitalization. Having neurologic features and drug therapy problems among neonates with sepsis prolonged hospital stay. Conclusion: The mean length of stay varies with respect to maternal and neonatal factors. Lower birth weight, presence of neurologic features, presence of comorbidity, presence of drug therapy problems and being male are found to be predictors of a longer hospital stay among neonates with sepsis. [ABSTRACT FROM AUTHOR]

A retrospective observational study of 1,160 prescriptions with prescribing errors from a large academic hospital in Thailand from 2014 to 2017. The aims of this study are to explore the proportion of prescribing error from pre-printed prescriptions and measure the frequency of prescribing errors in pre-printed versus hand-written prescriptions. Prescriptions with prescribing errors were stratified sampling and bootstrap resampling, then classified into 1) pre-printed historical medication prescriptions or pre-printed prescriptions 2) hand-written prescriptions. Some missed prescribing errors of each type of prescription were more identified by comparing the prescriptions with the medical records. Pre-printed prescriptions with prescribing errors constituted 767 (66%) of all collected prescriptions. The most commonly encountered prescribing error was "incomplete medication list in medical record", while 393 (34%) hand-written prescriptions were found to have the wrong dosage strength. Hand-written prescriptions were 1.45 times more likely to have a major error compared to pre-printed prescriptions (OR: 1.45, 95%CI: 1.08-1.94, P 0.012). Although using pre-printed prescription can reduce some prescribing errors such as wrong dosage strength that occur with hand-written prescriptions, pre-printed prescriptions were found to have other prescribing errors. Procedures to improve the prescribing system to increase patient safety are needed. [ABSTRACT FROM AUTHOR]

The aim of this paper is to investigate and analyze the behavior of charged compact stars in the modified f (R , ϕ , χ) theory of gravity. When solving the field equations, we assume that Krori– Barua space-time describes the geometry of the inner space [K. Krori and J. Barua, A singularity-free solution for a charged fluid sphere in general relativity, J. Phys. A Math. Gen.  8 (1975) 508]. We further analyzed various physical characteristics for our model, including energy density, pressure components, anisotropy parameter, mass function, compactness element, and redshift through their graphical representations. Additionally, we have checked the equilibrium position by taking Tolman–Oppenheimer–Volkoff equation and stability by using Abreu's criterion [H. Abreu, H. Hernandez, and L. Nunez, Sound speeds, cracking and the stability of self-gravitating anisotropic compact objects, Class. Quantum Grav.  24 (2007) 4631] and relativistic adiabatic index. For our study, we choose Hercules XI, Centaurus XIII, EXO 1785-248, LMC XIV stars for analysis. [ABSTRACT FROM AUTHOR]

Introduction: Nowadays, antibiotics are not correctly used among some dental practitioners. Thus, the misuse of antibiotics could lead to antibiotic resistance in the long run. The aim of this study was to evaluate the prescribing attitudes of dental practitioners in Northern Morocco when treating pulpal and periapical pathologies. Materials and Methods: This cross-sectional study involved 220 dental practitioners registered on the board of the National Council Order of Dentists of Morocco. A self-administered questionnaire, regarding the types of antibiotics used for endodontic treatment in healthy adult patients with endodontic pathological situations, was used and filled out via the E-mail addresses of practitioners chosen randomly. The data were analyzed with Jamovi (version 1.8.1). Quantitative variables were expressed as mean and standard deviation and qualitative variables as number and percentage. The Chi-square and the ANOVA tests were performed. The significance level was P < 0.05. Results: Forty percentage of dental practitioners prescribed amoxicillin as a first-line therapy for a patient who does not have a penicillin allergy and for patients with a penicillin allergy; azithromycin was the drug of choice prescribed by 41.1% of practitioners. The duration of prescription was 6.5 days ± 0.7. No statistically significant difference was noted regarding the duration of the prescription, in relation to age, sex, specialization, and country of graduation (P > 0.05). The acute apical abscess represents the pathology for which most antibiotics are prescribed. Practitioners aged between 24 and 35 years prescribe more than the oldest practitioners (P = 0.04). Antibiotics were also prescribed for the management of pulpitis and chronic apical periodontitis. The lowest prescription rates were noted among practitioners specializing in or having benefited from endodontic training. Conclusion: It emerges from this study that very few practitioners use antibiotics appropriately in treating pulpal and periapical pathologies. A real lack of knowledge has been noted with regard to indications, dosages, and duration. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) compromises global health due to the associated morbidity, mortality, and costs. The inappropriate use of antimicrobial agents is a prime driver of AMR. Consequently, it is imperative to gain a greater understanding of current utilization patterns especially in high-risk groups including neonates and children. A point prevalence survey (PPS) was conducted among three tertiary care children's hospitals in the Punjab province using the World Health Organization (WHO) methodology. Antibiotic use was documented according to the WHO AWaRe classification. Out of a total of 1576 neonates and children, 1506 were prescribed antibiotics on the day of the survey (prevalence = 95.5%), with an average of 1.9 antibiotics per patient. The majority of antibiotics were prescribed in the medical ward (75%), followed by surgical ward (12.8%). Furthermore, 56% of antibiotics were prescribed prophylactically, with most of the antibiotics (92.3%) administered via the parenteral route. The top three indications for antibiotics were respiratory tract infections (34.8%), gastrointestinal infections (15.8%), and prophylaxis for medical problems (14.3%). The three most common antibiotics prescribed were ceftriaxone (25.8%), amikacin (9.2%), and vancomycin (7.9%). Overall, 76.6% of the prescribed antibiotics were from Watch category followed by 21.6% from the Access group. There was a very high prevalence of antibiotic use among hospitalized neonates and children in this study. Urgent measures are needed to engage all the stakeholders to formulate effective ASPs in Pakistan, especially surrounding Watch antibiotics. [ABSTRACT FROM AUTHOR]

Palladium-catalyzed cross-coupling reactions of polyhalogenated heterocycles provide a convenient access to multifold arylated and alkynylated ring systems with a broad spectrum of physical and medicinal properties. Products include thiophenes, selenophenes, pyrroles, indoles, furans, benzofurans, pyrazoles, pyridines, quinolines, pyrimidines, pyrazines, naphthyridines, quinoxalines, and others. The regioselectivity of the coupling reactions is controlled by a combination of electronic and steric parameters. While a number of couplings can be carried out essentially under standard conditions, others require the use of more sophisticated ligands and a thorough optimization of the conditions, such as solvent, temperature, or reaction time. The present Account provides a personalized overview of coupling reactions of polyhalogenated heterocycles. 1 Introduction 2 Thiophenes 3 Selenophenes 4 Pyrroles and Indoles 5 Furans and Benzofurans 6 Pyrazoles 7 Pyridines 8 Quinolines 9 Pyrimidines and Pyrazines 10 Naphthyridines and Quinoxalines 11 Miscellaneous 12 Conclusions [ABSTRACT FROM AUTHOR]

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Antimicrobial resistance (AMR) is a leading global health threat, increasing morbidity, mortality, and costs, with excessive and irrational use of antimicrobials contributing to the development of AMR. Consequently, the aims of this study were to evaluate the understanding of antibiotic use, AMR, and antimicrobial stewardship programs (ASPs) among pharmacy technicians serving in ambulatory healthcare settings in Pakistan. A cross-sectional survey was conducted among pharmacy technicians serving in 144 ambulatory care settings in seven districts of Punjab province using a validated questionnaire. Overall, 376 technicians completed the survey (85.8% response rate). The majority were men (89.1%), aged 25–35 years (45.1%), serving in emergency departments (43.9%) and filling 31–60 prescriptions per day (37.5%). Most (79.5%) knew that antibiotics were one of the most frequently prescribed drug classes, while 59.8% believed antibiotics for common colds did not speed up recovery. Inadequate duration (59.6%) and inadequate dosages (57.7%) of antibiotic therapy were reported as the leading causes of AMR. Terms including 'superbugs', 'multidrug resistance', and 'extensively drug resistance' were known to 42.0%, 25.3%, and 20.7% of participants, respectively; however, <10% knew about ASPs, including their core elements and purpose. Our study revealed that pharmacy technicians have adequate awareness of antibiotic use but are currently unaware of AMR and ASPs, which is a concern. [ABSTRACT FROM AUTHOR]

Aphids (Hemiptera: Aphididae) are small soft-bodied sap-sucking insects with about 5,000 described species worldwide. Many of the aphid species are destructive pests of a wide array of horticultural and agricultural plants. This study determined the prevailing diversity of aphids on different economically important plantations in district Sargodha. From November to April 2018-2019 and 2019-2020, about 51,000 apterous adult aphid specimens were collected from various plantations from all six tehsils of district Sargodha and were identified up to species level. Richness and relative abundance of different aphid species were determined by calculating Shannon Wiener's (H'), Evenness (J'), Dominance (D) and Sampson's diversity indices. Results revealed a total of 19 aphid species belonging to 12 genera from district Sargodha. Brevicoryne brassicae was recorded as the most abundant species with 8,470 (16.6%) specimens, followed by Myzus persicae with 6,655 (13%) and Aphis gossypii with 5,348 (10.5%) specimens. While, Sitobion rosaeformis with 276 (0.5%) and Aphis nerii with 210 (0.4%) specimens were recorded as the least abundant species. Maximum aphid diversity was recorded on cereal and oilseed crops, while minimum was observed on loquat and citrus plantations. Moreover, maximum aphid population was recorded in the 1st fortnight of March in most plantations sampled. These results demonstrate the prevailing diversity of this economically important family of pest insects and would be helpful in future studies regarding their management. [ABSTRACT FROM AUTHOR]

Background: Antibiotics misuse is a global challenge, and the situation is likely to deteriorate in conflict zones with insufficient health services. The misuse of antibiotics is not only associated with antimicrobial resistance but may also lead to serious consequences. This study was aimed to investigate the knowledge, attitude, and practices on antibiotic consumption, antibiotic resistance (ABR), and related suggestions among residents of conflicted zones in Pakistan. Methods: Semi-structured interviews were conducted at community pharmacies between June 2020 and January 2021. The primary findings were ascertained through thematic content analysis. Themes, sub-themes, and categories were drawn from the final analysis. Data analysis was carried out in six steps from getting to know the data to final report development. Results: A total of 20 consumers were interviewed with a mean interview duration of 25.4 min. The average age of participants was 35.1 years, and most of them were males. ABR was unfamiliar to the participants. Most of the participants understood the term "antibiotics," but they did not know how to use them properly. The participants were unable to distinguish between bacterial and viral illnesses. Thirteen participants believed that antibiotics have a faster effect than any other drug. Most of the participants perceived that every antibiotic could cause diarrhea, and pharmacy staff sometimes prefer other medicines such as multivitamins. Consumer practices regarding antibiotic usage and ABR were found to be poor. Most participants recommended that health officials must ensure qualified staff at pharmacies with strict regulations. Five participants said that a leaflet with antibiotic instructions in Urdu (national language) is usually beneficial, especially when making solutions from powder. Conclusions: This study underscored poor knowledge, attitude, and practices among residents of conflicted zones towards antibiotics and ABR. Low literacy rate, unavailability of healthcare facilities, absence of pharmacists at community pharmacies, and uncontrolled sales of antibiotics are some factors attributed to serious hazards, ABR, and irrational use of drugs. [ABSTRACT FROM AUTHOR]

Background: Worldwide, microbes are becoming more challenging by acquiring virulent skills to adapt and develop antimicrobial resistance (AMR). This is a concern as AMR increases morbidity, mortality, and costs. Consequently, physicians need to be trained on appropriate antimicrobial prescribing, starting as medical students. Objective: To evaluate medical students' confidence in antimicrobial prescribing and AMR. Methods: Cross-sectional study assessing medical students' knowledge, perception, and confidence in prescribing antimicrobials and AMR in a Malaysian University. A universal sampling method was used. Results: Most responding students believed that educational input regarding overall prescribing was sufficient. Regarding the principle of appropriate and accurate prescriptions, female medical students had less knowledge (odds ratio (OR) = 0.51; 95% confidence interval (CI) 0.25–0.99; p = 0.050). Year-IV and Year-V medical students had more excellent knowledge than Year-III students regarding confidence in potential antibiotic prescribing once qualified. Year-V students also showed an appreciably higher confidence in the broad principles of prescribing, including antibiotics for infectious diseases, compared to those in other years. Conclusion: Overall, medical students gain more knowledge and confidence regarding the potential prescribing of antimicrobials as their academic careers progress. This is important given concerns with the current excessive use of antimicrobials in Malaysia. [ABSTRACT FROM AUTHOR]

This study explores the anisotropic stellar structures in the background of f(R) modified gravity, where R is a Ricci scalar. To complete this analysis, we use the spherically symmetric space-time. Further, an anisotropic source of matter is used to investigate the stability of stellar structures. The embedded class-I approach is used to demonstrate the behavior of stellar structures. Schwarzschild space-time is taken as exterior space-time to calculate the values of involved parameters. The observational data of three different stars, like LMC X-4, Cen X-3, and EXO 1785-248, are taken for the current analysis. For this study, we used Starobinsky-like model f(R) = R + βR2 for f(R) modified gravity. The stability analysis is discussed via the equation of state (EoS) parameters, Tolman–Oppenheimer–Volkoff (TOV) equation, anisotropy, etc. Graphical and analytical results are provided as viable results in f(R) gravity. [ABSTRACT FROM AUTHOR]

In this manuscript, an Energy Management System (EMS) in distribution system with Internet of Things (IoT) using hybrid approach is proposed. The proposed approach is the combination of Shuffled Shepherd Optimization (SO) and Feedback Artificial tree (FAT) algorithm and hence it is named SOFAT technique. The major intention of the proposed work is "to optimally maintaining the power and resources of distribution system by constantly monitor the data from the IoT-based communication framework". Here, the distribution system is integrated to data acquisition module that is an IoT object with unique IP address resulting in a large mesh wireless network devices. The IoT-based communication framework is utilized to facilitate the demand response (DR) EMS development in distribution system. The framework collects the DR from load and transmits the data to the centralized server. The transferred data is activated by SOFAT approach. In distribution system, the IoT structure increases these networks flexibility and provides optimum usage of available resources. In addition, the proposed approach is responsible to satisfy the overall supply and energy requirements. Finally, the proposed approach is carried out in MATLAB/Simulink, its efficiency is analyzed with other existing approaches. [ABSTRACT FROM AUTHOR]

Background: Insufficient antimicrobial-related training for physicians during their undergraduate education could have a negative impact on their prescribing. Unlike previous studies, this study not only explored the understanding and perception of Pakistani medical students about antibiotics and resistance, but also their preparedness towards antimicrobial stewardship programs. Methods: An online cross-sectional study was undertaken with final-year medical students using a validated questionnaire from January 2021 to May 2021. Descriptive and inference statistics were applied for data analysis. Results: Of 411 students, only 6.3% had undergone antimicrobial resistance (AMR) training. 16.1% of students believed that antibiotics are effective for viral ailments. More than half of the students agreed that AMR is a major healthcare problem in Pakistan (65.9%). Most students viewed poor infection control practices (66.9%), the use of too many broad-spectrum antibiotics (68.4%) for a longer duration (62.8%) with inadequate doses (67.9%) as the causes of AMR. The student's preparation was insufficient in interpreting microbiological and pathological results (26.3%), selecting the correct antibiotics (22.1%), and awareness of the antibiotic spectrum (20.9%). The median preparedness score showed significant differences with sex (p = 0.049), age (p < 0.001), institute type (p = 0.014), and family income (p = 0.006). Conclusion: Pakistani medical students showed adequate understanding of antibiotics, but lacked preparedness for several components of ASPs, including interpretation of microbiological results and spectrum of antibiotics. More steps need to be taken to prepare medical students for AMR and stewardship initiatives adequately. [ABSTRACT FROM AUTHOR]

Though antimicrobial stewardship (AMS) programmes are the cornerstone of Uganda's national action plan (NAP) on antimicrobial resistance, there is limited evidence on AMS attitude and practices among healthcare providers in health facilities in Uganda. We determined healthcare providers' AMS attitudes, practices, and associated factors in selected health facilities in Uganda. We conducted a cross-sectional study among nurses, clinical officers, pharmacy technicians, medical officers, pharmacists, and medical specialists in 32 selected health facilities in Uganda. Data were collected once from each healthcare provider in the period from October 2019 to February 2020. Data were collected using an interview-administered questionnaire. AMS attitude and practice were analysed using descriptive statistics, where scores of AMS attitude and practices for healthcare providers were classified into high, fair, and low using a modified Blooms categorisation. Associations of AMS attitude and practice scores were determined using ordinal logistic regression. This study reported estimates of AMS attitude and practices, and odds ratios with 95% confidence intervals were reported. We adjusted for clustering at the health facility level using clustered robust standard errors. A total of 582 healthcare providers in 32 healthcare facilities were recruited into the study. More than half of the respondents (58%,340/582) had a high AMS attitude. Being a female (aOR: 0.66, 95% CI: 0.47–0.92, P < 0.016), having a bachelor's degree (aOR: 1.81, 95% CI: 1.24–2.63, P < 0.002) or master's (aOR: 2.06, 95% CI: 1.13–3.75, P < 0.018) were significant predictors of high AMS attitude. Most (46%, 261/582) healthcare providers had fair AMS practices. Healthcare providers in the western region's health facilities were less likely to have a high AMS practice (aOR: 0.52, 95% CI 0.34–0.79, P < 0.002). In this study, most healthcare providers in health facilities had a high AMS attitude and fair AMS practice. [ABSTRACT FROM AUTHOR]

In this article, we aim to investigate some cylindrically symmetric solutions in a very well known modified theory named as f (R , ϕ , X) theory of gravity, where the terms R, ϕ and X are clarified as Ricci Scalar, scalar potential, and kinetic term respectively. For this purpose, we consider the cylindrically symmetric space-time to discuss the cylindrical solutions in some realistic regions. We further discuss six distinct cases of exact solutions using the field equations of f (R , ϕ , X) modified theory of gravity. Furthermore, we set some suitable values of U 0 and α in f (R , ϕ , X) = R + α R 2 - V (ϕ) + X for the investigation of well-known Levi–Civita and cosmic string solutions. The Energy conditions are also investigated for all different cases and observed that null energy conditions are violated, which is the indication of the existence of cylindrical wormholes. [ABSTRACT FROM AUTHOR]

Objective: To compare derangement of cerebrospinal fluid markers in neonates with early and late-onset sepsis managed at the Neonatal Intensive Care Unit. Study Design: Comparative cross-sectional study. Setting and Duration of Study: Neonatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2021 to Jun 2022. Methodology: This study was conducted on neonates managed at our Neonatal Intensive Care Unit for late or early-onset sepsis. A consultant neonatologist diagnosed neonatal sepsis based on clinical and laboratory findings. The cerebrospinal fluid routine examination was performed on all the study participants, and the derangement of various markers was compared in neonates with early and late-onset sepsis. Results: A total of 348 neonates admitted to the neonatal intensive care unit with sepsis were included in the final analysis. The mean age of the newborns included in the study was 5.38±4.53 days. Out of all the neonates in the study, 194(55.7%) had early-onset sepsis, while 154(44.3%) neonates had late-onset sepsis. All the cerebrospinal fluid markers were statistically significantly deranged in patients with late-onset sepsis (p-value<0.005). Conclusion: Derangement of cerebrospinal fluid markers was seen more in patients with late-onset neonatal sepsis admitted to the neonatal intensive care unit. Emphasis should be laid on performing this necessary investigation timely in neonates with late-onset sepsis as chances of meningeal involvement are higher in this group. [ABSTRACT FROM AUTHOR]

Introduction: There is a lack of research regarding dentists' knowledge and their drug prescription practices, despite analgesics and antibiotics being frequently prescribed by dental practitioners. Prescription errors can be attributed to deficient training of dental students. This research was carried out to examine dental students' familiarity with common drugs and whether these future graduates would be proficient in drug prescription. Study design and setting: Cross-sectional study carried out at Watim Dental College, Rawat in April, 2023. Methodology: A questionnaire consisting of 10 close-ended questions was used in this study which was conducted among 180 students of Watim Dental College. The data was analyzed using spss 26 to produce descriptive statistics, contingency tables and to run chi-square test. Results: The chief reason for prescribing medication was pain with Paracetamol being the most frequently recommended analgesic and Amoxicillin, the most commonly prescribed antibiotic. Not asking patients about drug allergies was the most common prescription error. The majority of the students used Pharmacology text books as a guide and were familiar with the WHO Guide to Good Prescribing. As the students entered their clinical years (third and final year), their drug knowledge improved which was statistically significant (p value=0.002) Conclusion: The knowledge of pharmacology among students at Watim Dental College has gaps that could be a concern to the wellbeing of the patients. Whether this affects the success and safety of treatments needs to be evaluated by further studies. It is essential to develop strict therapeutic guidelines and to deliver pharmacological therapy courses to ensure accurate drug prescription practices. [ABSTRACT FROM AUTHOR]

The goal of this work was to investigate the behavior of charge compact stars in the context of f (G) theory of gravity, which is one of the most powerful candidates responsible for the accelerated expansion of the universe. The salient feature of the current research is the consideration of Bardeen's model, which describes an exterior space-time and interprets the magnetic monopole arising from gravity collapse caused by some specific conditions of nonlinear electrodynamics. Moreover, we analyzed the structure of the star by using the solution provided by a Finch-Skea-type metric potential. All the physically necessary parameters and characteristics of relativistic spheres are displayed graphically. We further studied the energy density, pressure curves, equation-of-state parameters, anisotropy factor, energy conditions, Tolman-Oppenheimer-Volkoff equation, redshift functions, compactness parameters, adiabatic index, and stability analysis in detail. Key words: modified f (G) gravity, Bardeen compact stars, equation of state, Finch-Skea metric, energy conditions Le but de ce travail est d'examiner le comportement des etoiles compactes chargees dans le contexte de la theorie de la gravite f (G), qui est l'un des plus puissants candidats pour decrire l'expansion acceleree de l'univers. La caracteristique particuliere de cette recherche est de considerer le modele de Bardeen qui decrit un espace-temps exterieur et interprete le monopole magnetique provenant de l'effondrement gravitationnel cause par certaines conditions specifiques de l'electrodynamique non lineaire. De plus, nous analysons la structure de l'etoile en utilisant la solution fournie par le potentiel de type metrique de Finch-Skea. Tous les parametres necessaires physiquement et les caracteristiques des spheres relativistes sont presents graphiquement. Nous etudions aussi en detail la densite d'energie, les courbes de pression, les parametres de l'equation d'etat, le facteur d'anisotropie, les conditions sur l'energie, l'equation de Tolman-Oppenheimer-Volkoff, les fonctions de decalage vers le rouge, les parametres de compacite, l'index adiabatique et l'analyse de stabilite. [Traduit par la Redaction] Mots-cles: gravite modifiee f (G), etoiles compactes de Bardeen, equation d'etat, metrique de Finch-Skea, conditions d'energie, 1. Introduction In 1916, Einstein suggested the relativity theory of gravitational force. This theory of general relativity (GR) explains the gravitational interaction induced by the curvature of space-time caused by [...]