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Antibiotic resistance is a critical global health challenge that threatens the efficacy of modern medicine and public health. As frontline healthcare providers, pharmacists play a vital role in combating this issue through their expertise in medication management, patient education, and collaboration with other healthcare professionals. This review explores various strategies that pharmacists can employ to minimize antibiotic resistance, emphasizing their unique perspectives and contributions. One of the primary strategies involves promoting appropriate antibiotic use through participation in antimicrobial stewardship programs (ASPs). Pharmacists can conduct medication reviews to assess the appropriateness of antibiotic therapy, ensuring that antibiotics are prescribed only when necessary and that the most effective agents are selected. Additionally, pharmacists can educate patients about the importance of adhering to prescribed regimens and the potential consequences of misuse, thereby enhancing patient awareness and responsibility. Enhancing patient education is another critical component of minimizing antibiotic resistance. Pharmacists can address common misconceptions about antibiotics, providing clear information on when antibiotics are appropriate and when they are not. By utilizing effective communication strategies, pharmacists can foster open dialogue with patients, building trust and promoting adherence to responsible antibiotic use. Collaboration among healthcare professionals is essential for effective antibiotic stewardship. Pharmacists can work closely with physicians, nurses, and infection control teams to ensure that antibiotic prescribing practices align with current guidelines. By participating in interdisciplinary rounds and educational initiatives, pharmacists can share their expertise and contribute to optimizing antibiotic therapy. The integration of technology and data analytics into pharmacy practice also offers significant potential for minimizing antibiotic resistance. Pharmacists can leverage electronic health records and clinical decision support systems to monitor prescribing patterns and identify areas for improvement. In conclusion, pharmacists are integral to strategies aimed at minimizing antibiotic resistance. Through their proactive involvement in stewardship programs, patient education, interdisciplinary collaboration, and the use of technology, pharmacists can significantly contribute to the fight against antibiotic resistance, ultimately safeguarding public health and enhancing patient outcomes.

This study focuses on the multidisciplinary investigation of three stucco-shrouded mummies with mummy portrait from Egypt dating from the late 3rd to the middle of the 4th century AD, corresponding to the late Roman Period. These three mummies were excavated in the early 17th and late 19th centuries in the Saqqara necropolis near the ancient Egyptian capital of Memphis. Two of them experienced an interesting collection history, when they became part of the collection of the Elector of Saxony and King of Poland August II in Dresden, Germany, in 1728. The investigation includes information about the mummies' discovery, collection history and shroud decoration obtained through Egyptological expertise. In addition, information on the state of preservation, technique of artificial mummification, age at death, sex, body height and health of the deceased was achieved through computed tomography (CT) analysis. Research yielded an adult male, a middle-aged female and a young female. Due to the rather poorly preserved bodies of the male and middle-aged female, a specific technique of artificial mummification could not be ascertained. Brain and several internal organs of the well-preserved young female were identified. Wooden boards, beads of necklaces, a hairpin, and metal dense items, such as lead seals, nails and two coins or medallions were discovered. Paleopathological findings included carious lesions, Schmorl's nodes, evidence of arthritis and a vertebral hemangioma. The study revealed insights on the decoration and burial preparation of individuals of upper socioeconomic status living in the late Roman Period, as well as comprehensive bioanthropological information of the deceased.

Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001). Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant.

Background Achieving sustainable performance in healthcare organizations has become a pressing necessity, driven by environmental challenges and the imperative for enhanced efficiency. Within nursing leadership, the integration of green absorptive capacity, green intellectual capital, and green knowledge management has emerged as a strategic approach to fostering sustainability. However, empirical research on the interplay of these green competencies in the nursing sector remains limited. Aim This study aims to examine the mediating role of green knowledge management (GKM) in the relationships between green absorptive capacity, green intellectual capital, and sustainable performance among nursing managers. It explores how GKM processes translate environmental competencies into sustainable leadership outcomes. Methods A cross-sectional descriptive correlational study was conducted among 207 nursing managers at Zagazig University Hospitals, Egypt. Data was collected using five validated instruments, including the Green Absorptive Capacity Questionnaire, Green Intellectual Capital Questionnaire, Sustainable Performance Questionnaire, and Green Knowledge Management Scale. Structural equation modeling and path analysis were performed to test the study hypotheses. Results The findings revealed significant positive associations between green absorptive capacity (β = 0.123, p  < 0.001), green intellectual capital (β = 0.064, p  = 0.016), and sustainable performance among nursing managers. Green knowledge management exhibited the strongest direct effect on sustainable performance (β = 0.727, p  < 0.001). Additionally, green knowledge management significantly moderated the relationships between green absorptive capacity and sustainable performance (β = 0.256, p  < 0.001) as well as between green intellectual capital and sustainable performance (β = 0.359, p  < 0.001). These results underscore the pivotal role of knowledge-driven sustainability strategies in nursing leadership. Conclusion This study highlights the importance of integrating green absorptive capacity, green intellectual capital, and green knowledge management into nursing leadership to enhance sustainability outcomes. The findings provide empirical evidence for the need to embed green competencies within nursing management, advocating for policies and training programs that reinforce environmental responsibility in healthcare institutions. Clinical trial number Not applicable.

Cancer patients are more susceptible to several bacterial infections, particularly urinary tract infections caused by uropathogenic E. coli (UPEC). The objective of this work was detection and the phylogenetic characterization of hospital-acquired isolates of uropathogenic E. coli in cancer patients and the determination of its relation with antibiotic resistance. A total of 110 uropathogenic E. coli responsible for hospital-acquired urinary tract infections in cancer patients were included in this study. A triplex PCR was employed to segregate different isolates into four different phylogenetic groups (A, B1, B2 and D). Drug resistance was evaluated by the disc diffusion method. All of the isolates were multiple drug-resistant (MDR) and 38.18% of all UPEC isolates were extended-spectrum beta-lactamase (ESBL) producers from which 52% were positive for the blaCTX-M gene, 40% for the blaTEM gene, and 17% for the blaSHVgene. Among 42 ESBL-producing uropathogenic E. coli isolates, the majority belonged to phylogenetic group B2 (43%), followed by group D (36%), group A (19%) and group B1 (2%). Our results have shown the emergence of MDR isolates among uropathogenic E. coli with the dominance of phylogenetic group B2. Groups A and B1 were relatively less common. The most effective drug in all phylogenetic groups was imipenem.

Background: Diabetes mellitus is a metabolic illness that is non-communicable, chronic, and associated with hyperglycemia. It is caused by a combination of the incapability of tissues that exhibit sensitivity to insulin in response to its release & defective secretion of insulin by β-cells of the pancreas.Aim: To assesses efficiency of a combination of amoxicillin-metronidazole in enhancing periodontal variables in type 2 diabetes cases in comparison with standard periodontal treatment.Materials and methods: This systematic review has been performed on four studies regarding the guidelines by the Cochrane Collaboration reporting followed the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-analyses).Results: All four investigations demonstrated that systemic amoxicillin– metronidazole enhanced periodontal health when utilized in combination with nonsurgical periodontal treatments. Miranda et al. & El Makaky et al. illustrated significant decreases in probing depth (PD), bleeding on probing (BOP) & clinical attachment loss (CAL) at 3 months when systemic amoxicillin–metronidazole has been utilized in comparison to deferred management or scaling & root planning (SRP) alone.Conclusion: This systematic review proposed that the combination of nonsurgical periodontal treatments with systemic amoxicillin–metronidazole may result in improved clinical results. Disparities have been noted in the antibiotic prescriptions' durations and dosages, as well as in the management's conducted to the control groups.

In this present investigation we report the green synthesis of siver nanoparticle (AgpNs) by using the leaf extract of three herb exRosemary officinalis , Punica granatum, Artemisia vulgaris Keywords:Nanoparticle , green herb, pathogenic bacteria , antibacteroial Introduction Nanotechnology provides aessential oil have been kown good plant form to modify and develop the important properties of metal in the form of nanoparticles having promsing application in diagnostic , biomarkers, cell labelling(1, 2 ), contrast agents for biological imaging, antimicrobial agent, drug delivery systems and nanodrug for treatment of various disease(1, 2 ). Preparation of Extracts All plant sample extracts were washed, dried under room temperature and converted to powder using mechanical grinder, 150 g of each plant powder wasindividually packed in thimple of soxhlet apparatus and extracted with 1000 ml of aqueous ethanol(thanol water80-20 v/v) for 12 each extract was filtered and concentrated under vacuum using arotary evaporator to get dry residue. [...]proposed the AgNps will have agreementt potential in anti MRbacteria (18 ). Both the component of metallic silver antibacterial and metabolic of plant has antibacterial well kow nanoparticle develop mechanisim nanoparticle adhere to the cell wall and increase the pore size of cell membrane which altimately facilities the plant metabolite to enter in the cell or interrupt the bacterial colonization.

Background: The study aimed to evaluate the direct effects of packed red blood cells (PRBCs) transfusions on neonatal blood lead levels (BLL) among the neonates admitted to Cairo University Pediatric Hospital (CUPH). Methods: It is a prospective cohort study including fifty-four premature neonates which took place over a period of 6 months starting from January 2018. Baseline and post-transfusion BLL were obtained. Neonatal BLL percent change was calculated to quantify the change levels before and after transfusion. Results: The neonatal BLL after transfusion was elevated one and half times more than that before transfusion. The median neonatal BLL% change was significantly higher in neonates diagnosed with extremely low birth weight and neonatal sepsis. BLL after transfusion showed a positive, moderate and significant relationship with neonatal weight, lead level in blood packs, gestational age, and blood creatinine level respectively. Multiple regression was used to explore the relationship between BLL% change and a number of predictors (e.g. neonatal age, weight, gestational age, number of transfusion times and lead level in blood packs). Conclusions: The study concluded that preterm neonates are at risk of lead exposure hazards due to receiving PRBCs transfusions. Higher lead levels in PRBCs denotes exposure of donors to higher lead levels and accordingly the recipient preterms.

Renal cell carcinoma (RCC) is a common renal malignancy that frequently metastasizes, though cutaneous metastasis, particularly to the scalp, is rare and generally indicates a poor prognosis. We report a case of scalp metastasis from RCC in a 69-year-old man who presented with unexplained weight loss and painless hematuria. Imaging revealed a 12-cm renal mass with adrenal, pulmonary, and scalp metastases. The patient's condition rapidly deteriorated, and he died one month after the presentation. Hematogenous spread through Batson's plexus might be the primary mechanism of RCC dissemination to the scalp. While targeted therapies have improved the management of metastatic RCC, the prognosis for patients with skin metastases remains poor.