Antimicrobial resistance (AMR) poses an immense worldwide health threat, predicted to result in as many as 10 million mortalities by 2050. With the stagnation of antibiotic discovery as well as the rapid growth of multidrug-resistant pathogens, novel therapeutic strategies are urgently required. Microbes engineered or naturally therapeutic—offer innovative approaches for targeted pathogen elimination. These include bacteriophage therapy, engineered probiotics, synthetic biology-based organisms, and microbial consortia. This review synthesizes recent advances, evaluates their clinical potential, and highlights the limitations, regulatory obstacles, and future potential for these novel therapies. Collectively, microbial-based interventions represent a promising, yet underutilized, frontier within the fight over AMR.

Rhinoplasty (RPT) is one of the most commonly performed cosmetic and functional procedures in facial plastic surgery worldwide. More than 200,000 cases are performed each year in the United States. This reconstruction technique is rarely performed in West Africa. After reviewing the literature, no cases have been reported to date. It is in this context that we undertook this work, which aims to describe the technical aspects and results of a functional rhinoplasty case treated in the maxillofacial and plastic surgery department of the military hospital in Dakar, with a review of the literature. We report on closed rhinoplasty for post-traumatic nasal deviation with functional impairment in a 31-year-old police officer who was referred to the department for a specialist consultation reconstructive plastic surgery. The surgical approach consisted of nasal reconstruction combined with septoplasty using the endonasal approach technique under general anesthesia. Four months after surgery, the patient was very satisfied with the morphological and functional results. African noses are generally described as having thick skin and abundant subcutaneous fibro-adipose tissue. The success of the procedure is based on functional and/or aesthetic results and is reflected in patient satisfaction. This African rhinoplasty requires a fundamental understanding of acceptable beauty standards, the associated psychological underpinnings, and the facial and nasal characteristics specific to Africans. Considered one of the most complex procedures, this reconstruction technique deserves to be mastered and practised in Senegal and even in West Africa in order to reduce medical evacuations and medical tourism.

Objectives: To analyze the existing literature on the outcomes of metformin usage among prediabetic patients. Methods: A thorough search across four databases identified 914 relevant publications. After removing duplicates using Rayyan QCRI and screening for relevance, 77 full-text articles were reviewed, with 6 studies ultimately meeting the criteria for inclusion. Results: We included six studies with a total of 295 pre-diabetic patients and 197 (66.8%) were females. Across the included studies, metformin demonstrated consistent benefits in improving insulin sensitivity and lowering fasting glucose and HbA1c levels, particularly when combined with lifestyle interventions such as exercise. Several studies showed delayed or reduced progression to type 2 diabetes (T2D). Metformin was especially effective in individuals with higher baseline fasting plasma glucose or insulin resistance. Adverse effects were minimal and infrequently reported. However, metformin alone was not universally effective in preventing diabetes, emphasizing the importance of combined interventions. Conclusion: Metformin is a safe and effective adjunct therapy for delaying or preventing T2D in individuals with prediabetes, particularly when used alongside lifestyle changes. Early initiation may offer greater benefits in preserving insulin function and reducing β-cell stress. Future research should explore long-term outcomes and optimal patient selection criteria.

Leiomyosarcoma is a rare malignant tumor originating from smooth muscle cells, most commonly affecting the uterus, retroperitoneum, and extremities, while primary involvement of the abdominal wall is exceptionally uncommon. We report the case of a 55-year-old woman who presented with a progressively enlarging mass on the left abdominal wall over six months. Imaging studies revealed a 10 × 3.9 × 13 cm well-defined lesion arising from the external oblique muscle, without intra-abdominal extension or distant metastasis. A core needle biopsy demonstrated spindle-shaped tumor cells with elongated, hyperchromatic nuclei and eosinophilic cytoplasm. Immunohistochemical analysis showed positivity for smooth muscle actin (SMA), h-caldesmon, vimentin, CD68, and CD45, and negativity for pancytokeratin (AE1/AE3), desmin, CD34, S100, myogenin, MDM2, and EMA, confirming the diagnosis of a pleomorphic leiomyosarcoma rich in osteoclast-like giant cells (FNCLCC grade III). The patient underwent wide local excision with tumor-free (R0) margins. She did not receive adjuvant radiotherapy due to financial constraints. Histopathological examination of the surgical specimen confirmed the diagnosis and clear resection margins. At six months of follow-up, there was no evidence of local recurrence or metastasis. This case highlights the rarity of primary leiomyosarcoma of the abdominal wall and underscores the importance of imaging, histopathology, and immunohistochemistry for diagnosis. Complete surgical excision with negative margins remains the mainstay of treatment, and long-term follow-up is essential due to the risk of recurrence and metastasis.

Background: Thalassaemia remains a major public health concern in Bangladesh, where hereditary disorders are increasingly recognized as contributors to long-term morbidity. Junior doctors play a critical role in early identification, counselling and implementation of preventive strategies. This study aimed to evaluate the level of knowledge and attitude of junior doctors toward thalassaemia and compare findings between interns and medical officers. Methods: A hospital-based cross-sectional descriptive study was conducted among 110 junior doctors (interns and medical officers) in Gonoshasthaya Samaj Vittik Medical College, Savar, Dhaka, Bangladesh, from April to June 2019. Data were collected using a pre-designed, self-administered questionnaire comprising demographic variables, 20 knowledge items and 9 attitude items. Knowledge scores were categorized as good, average, or poor. Attitude scores were classified as positive or negative. Data were analyzed using SPSS. Results: Participants were predominantly aged 22–26 years (76.4%), female (63%) and interns (72.7%). Good knowledge was observed in 34.5%, while 34.5% had average and 30.9% had poor knowledge. Positive attitudes were noted in 81.8% of respondents. Interns demonstrated significantly better understanding of consanguinity (p=0.014), prevention (p=0.011) and routine investigations (p=0.008). All participants were willing to donate blood and 80% were willing to donate bone marrow. Knowledge and attitude showed a positive, though statistically insignificant, association. Conclusion: Despite favorable attitudes toward prevention, substantial knowledge gaps persist among junior doctors. Strengthened training in genetics and thalassaemia management is necessary.

This work is about searching the origins of life. So, different natural biochemical cycles-their precursors and end products were analysed. Ratios of interaction between different elemental atoms forming those precursors and end products were created and used to find out the possible precursor molecule of DNA. Efforts were also made to identify the length of time period of remaining ice house phase using a method developed to calculate areas above and below curves on graphs.

Aim: This study aimed to formulate and evaluate grainsetron HCl transdermal patches to reduce the problems associated with oral delivery of the drug and enhancement of drug permeation through the skin. Methods: Grainsetron HCl loaded transdermal patch were prepared by solvent evaporation method. Six formulations were prepared based on the two independent variables, type of surfactant and Phospholipid: Edge activator ratio and were evaluated for their vesicle size, PDI, and entrapment efficiency. The optimized formulations were incorporated into transdermal patches, which were evaluated for physicochemical properties ex-vivo permeation, skin irritancy, and stability studies. Result: Ex-vivo skin permeation study of optimized formulation NEB3 plot of cumulative amount of drug release versus time generate for Permeation studies. From this plot, permeation kinetic parameters such as permeation flux, permeability coefficient and enhancement ratio were calculated. The results showed that NEB3 with 30% w/w had a flux of 174.25±1.04 and released 65.21% in 720 minutes. The results of the in-vivo skin irritation study indicate that the optimized batch NEB3 did not cause significant irritation on rat skin for up to 14 days and was safely used for up to 24 hours. The stability of the optimized formulation (NEB3) was assessed at various temperatures over a period of 30 days. The optimized formulation was assessed for various parameters such as appearance, weight variation, folding endurance, tensile strength, and drug content. The evaluation showed no significant changes in the formulation under room, oven, and cold temperatures. Conclusion: The study concluded that transdermal patches of Grainsetron HCl could be used as a potential approach with effective transdermal delivery for the management of chemotherapy induced vomiting.

Introduction : Prostate cancer is the most common cancer in men over 65. Depression is frequent in this population but remains underdiagnosed, particularly due to atypical clinical presentations, confusion with treatment side effects, and sociocultural perceptions that trivialize the psychological distress of older adults. The objective of this study was to describe the obstacles to screening for depression in older patients treated for prostate cancer, analyze professional perceptions, and identify potential improvements to the care pathway. Methods : A qualitative study incorporating a clinical case of severe depression in a 76-year-old man treated with hormone therapy for prostate cancer, and semi-structured interviews conducted with a university hospital geriatrician and a geriatric psychiatrist. Results: Psychological vulnerability is increased by the cancer diagnosis, the loss of virility associated with treatment, geriatric frailty, and social isolation. Screening practices remain inconsistent: geriatricians used standardized tools, while psychiatrists intervened after the disorder had already developed. Identified obstacles included confusion between depressive symptoms and side effects, persistent taboos surrounding psychiatry, a lack of interdisciplinary coordination, and the absence of institutional protocols. Professionals agreed on the need for a structured screening protocol, targeted training, and interdisciplinary collaboration. Analysis of the literature and professional guidelines reinforced the need to implement a proactive screening approach, particularly at the initiation of hormone therapy. Conclusion : This study highlighted the need for a preventive and integrative approach to identify depression early in this high-risk population. Systematizing screening, adapting tools to the cultural context, and fostering collaboration among professionals working with older adults are essential to improving their quality of life and preventing suicidal complications.

The review paper explains the effects of data-driven transformation in healthcare on access to care and efficiency in the southwest part of Saudi Arabia, with focus on Jazan. Within the ambit of Saudi Vision 2030, several steps have been taken by the Kingdom to adopt digital health technologies that will help close the urban-rural healthcare gap. Utilization of telemedicine, mobile health applications, and AI-enabled diagnostics continues shaping much-needed changes in health delivery mechanisms in resource-poor areas by enhancing access to medical services for previously underprivileged rural populations alienated by geographical barriers, long travel distances to health facilities, unaffordable costs, and inadequate availability of both health facilities and personnel. Across the southwest of Saudi Arabia, where terrain and infrastructural challenges have historically obstructed access to healthcare, digital health initiatives like Seha Virtual Hospital (SVH), and Sehhaty App now play a crucial role in availing remote consultations, the management of chronic diseases, and delivery of care. The integration of electronic health records (EHR) and, in turn, AI tools will boost the efficiency of healthcare services through real-time data sharing, better allocation of resources, and lesser diagnostic errors. Yet, several challenges remain, including issues of internet connection in the rural space, digital literacy, preparedness of the workforce, and regulatory frameworks for telemedicine. These barriers need to be dealt with for the sustainable and equitable rollout of digital health solutions. This review elaborates on how data-driven transformation of healthcare could precipitate a favourable outcome in the health of the southwest region while laying down the challenges to be surmounted for this progress to continue with success. By and large, the data-driven health transformation in southwest Saudi Arabia presents a potential model for addressing disparities between urban and rural health, resulting in more efficient, accessible, and patient-centred care.

The study aimed to evaluate donor deferrals among individuals presenting for whole blood or platelet apheresis donation at King Abdullah Medical City in Makkah, Blood Bank Department, and to classify deferrals by screening stage. Category 1 deferrals included interview-based reasons such as recent travel to malaria-endemic areas, current medication use, or behavioral risk disclosures. Category 2 deferrals included clinical assessment findings such as low hemoglobin, abnormal blood pressure, and high body temperature. The study also evaluated the theoretical potential of telemedicine to reduce Category 1 deferrals through pre-donation screening. A retrospective cross-sectional study was conducted at the Blood Bank Department of King Abdullah Medical City in Makkah between January 2023 and December 2024. From 3,029 recorded deferrals, a systematic random sample of 385 deferred donors was selected for analysis. Each deferral was classified according to the screening stage. Descriptive statistics and Chi-square tests were used. A total of 385 deferred donors were analyzed. Of these, 260 (67.5%) were classified as Category 2 and 125 (32.5%) as Category 1. Gender was significantly associated with deferral category (χ²(1, N = 385) = 6.128, p = 0.013). Category 1 deferrals were more frequent among male donors (35.2%) than female donors (18.0%). Interview-based factors accounted for 32.5% of deferrals and could be identified in advance through structured remote screening methods such as tele-interviews, reducing the likelihood of unnecessary on-site visits. The study examined the theoretical role of telemedicine as a pre-donation triage tool, emphasizing its potential to decrease avoidable deferrals and strengthen donor retention through targeted early interventions.

Background: Lumbar intervertebral disc prolapses, commonly known as herniated disc, is a leading cause of chronic lower back pain and radicular pain, often necessitating surgical intervention when conservative treatments fail. This study compares the outcomes of unilateral fenestration and discectomy (UFD) versus bilateral fenestration and discectomy (BFD) in treating lumbar intervertebral disc prolapse. Objective: To evaluate the effectiveness of UFD and BFD in terms of pain relief, functional improvement, complication rates, and recovery times. Methods: This prospective study involved 200 patients diagnosed with single-segment lumbar disc herniation from January 2012 to December 2017. Patients underwent conservative treatment before surgical intervention. Group A received UFD, while Group B underwent BFD. Pain severity was assessed using the Visual Analogue Scale (VAS), and functional recovery was evaluated using the Oswestry Disability Index (ODI). Statistical analyses were performed using SPSS 19.0 software. Results: Group A (UFD) demonstrated superior perioperative and postoperative outcomes compared to Group B (BFD). Although demographic variables and herniation patterns were comparable between groups, Group A exhibited shorter surgical duration, lower intraoperative blood loss, and reduced postoperative analgesic requirements. Hospital stay and bed rest duration were significantly shorter in Group A, indicating faster recovery. Preoperative VAS-LP, VAS-BP, and ODI scores were similar in both groups; however, Group A showed greater reductions in pain and disability scores at early and late follow-up. Additionally, fewer postoperative complications were noted in Group A. These findings suggest that UFD leads to more efficient surgical recovery and improved early functional outcomes compared to BFD. Conclusion: UFD (Group A) provides clear advantages, including lower postoperative pain levels, reduced blood loss, shorter hospital stays, and faster overall recovery. These findings support UFD as a preferable surgical approach for appropriately selected patients, owing to its less invasive nature and superior short-term outcomes.

Radiology plays a crucial role in the management of stroke, particularly through the use of advanced imaging techniques such as CT scans and MRIs. These imaging modalities are essential for the rapid and accurate diagnosis of stroke types ischemic or hemorrhagic which significantly influences acute treatment decisions. Radiology not only helps in identifying the presence and extent of brain damage but also guides interventional procedures, like thrombectomy, during critical timeframes. In tandem, laboratory testing provides vital information regarding patient health and aids in determining underlying stroke risk factors. Tests such as complete blood counts, coagulation profiles, and lipid panels enable healthcare providers to tailor interventions based on individual patient needs, thereby optimizing outcomes. Preventive strategies and nursing care are fundamental in multifaceted stroke management, emphasizing the importance of risk factor modification and patient education. Preventive strategies focus on controlling hypertension, diabetes, and hyperlipidemia through medication and lifestyle changes, including diet and exercise. Nurses play a pivotal role in this preventative realm by delivering education on recognizing stroke symptoms, promoting adherence to treatment regimens, and providing support for smoking cessation or weight management. Furthermore, they are integral in the management and monitoring of acute stroke patients in clinical settings, ensuring timely intervention and facilitating rehabilitation efforts to promote optimal recovery. Their holistic approach not only addresses immediate medical needs but also fosters long-term health and well-being.

Medical devices have become indispensable in modern healthcare settings, fundamentally transforming clinical workflows and patient care delivery. However, despite significant technological advancements, the integration of medical devices into healthcare environments presents multifaceted challenges that directly impact both healthcare worker quality of life and patient safety outcomes. This comprehensive review synthesizes recent literature examining the relationship between medical device usability, human factors engineering principles, and the well-being of healthcare professionals including radiological technicians, health informatics specialists, nurses, clinical coding technicians, and health administration staff. The review examines critical factors including device usability design, ergonomic considerations, training adequacy, workflow integration, and psychological impacts including burnout and job satisfaction. Evidence demonstrates that while medical devices offer substantial benefits in terms of efficiency, accuracy, and clinical decision support, their implementation frequently encounters significant barriers related to poor usability, inadequate training, ergonomic challenges, and psychological stress among users. Key findings indicate that healthcare systems exhibiting structured training programs, user-centered design principles, and adequate organizational support demonstrate markedly superior outcomes in staff satisfaction, productivity, and patient safety. This review identifies essential strategies for optimizing medical device integration, including comprehensive human factors engineering evaluation during development, iterative usability testing with end-users, enhanced training protocols, workflow-centered design approaches, and institutional commitment to supporting staff adaptation and well-being during technology transitions.

Background: Surgical site infection (SSI) remains one of the most common postoperative complications, particularly in cases involving contaminated or dirty abdominal surgeries. Despite improved aseptic techniques and antibiotic prophylaxis, SSI continues to contribute significantly to morbidity, prolonged hospitalization, and increased healthcare costs, especially in developing countries. Intraoperative intraperitoneal antibiotic lavage, particularly using gentamicin, has been proposed as an effective adjunct to reduce microbial contamination and postoperative infection risk. Objective: The present study aimed to evaluate the effect of intraperitoneal gentamicin lavage on postoperative surgical site infection (SSI) in children undergoing dirty laparotomy. Methods: This randomized controlled trial was conducted at the Faculty of Pediatric Surgery, Bangladesh Shishu Hospital and Institute, Dhaka, from March 2018 to December 2019. A total of 70 children (≤5 years) undergoing laparotomy for dirty surgery were randomly divided into two groups. Group A (n=35) received intraperitoneal lavage with gentamicin diluted in normal saline (160 mg/500 ml), whereas Group B (n=35) received lavage with normal saline only. Postoperative outcomes, including fever, wound infection, wound dehiscence, secondary closure, and hospital stay duration, were recorded and analyzed using SPSS version 23. Results: The groups were comparable in age and gender distribution (p>0.05). Postoperative fever occurred in 54.3% of Group A and 77.1% of Group B (p=0.044), while wound infection rates were significantly lower in the gentamicin group (11.4%) than in the control group (31.4%) (p=0.041). Although wound dehiscence and secondary closure did not differ significantly between groups, the mean postoperative hospital stay was notably shorter in Group A (8.17 ± 2.70 days) compared to Group B (10.71 ± 3.89 days) (p=0.002). Conclusion: Intraperitoneal gentamicin lavage significantly reduced postoperative fever, wound infection rates, and hospital stay duration in children undergoing dirty laparotomy. These findings suggest that gentamicin lavage can serve as an effective adjunctive measure to minimize postoperative infectious morbidity and enhance recovery in pediatric contaminated abdominal surgeries.

A quality by design (QbD)-based on high resolution, stability-indicating high performance liquid chromatography (HPLC) method was developed for determining the impurities in Linezolid oral suspension dosage forms. Using this method six known were impurities qualified, and two degradants were quantified with excellent peak resolution. Using pH 3.0 0.02M potassium phosphate buffer as buffer. For mobile phase-A consisted of 80% buffer, acetonitrile 10%, and 10% methanol in the ratio of 80:10:10(v/v/v), while mobile phase B consisted of methanol and buffer in the ratio of 60:40, (v/v) methanol and buffer. The column was maintained at a temperature of 30°C, with a flow rate of 1.0 mL/min. UV wavelength at 254 nm. The method exhibited high specificity and demonstrated linearity over the concentration range of 0.502–6.025 µg/mL, with a correlation coefficient (r²) greater than 0.999. Accuracy exceeded 97%. The method was validated in accordance with the guidelines established by the International Council for Harmonisation (ICH), covering parameters such as specificity, linearity, precision, accuracy, and robustness. Forced degradation studies revealed that Linezolid oral suspension was sensitive to acid and oxidative stress conditions. The developed method is considered suitable for routine quality control applications, including impurity profiling and stability-indicating analysis of Linezolid oral suspension.

Introduction: McCune–Albright syndrome (MAS) is a rare, sporadic mosaic disorder caused by postzygotic activating mutations of the GNAS gene. It is classically characterized by a triad of polyostotic fibrous dysplasia, café-au-lait skin macules, and hyperfunctioning endocrinopathies. Growth hormone (GH) excess represents a particularly challenging manifestation and is most often associated with pituitary adenomas or somatolactotroph hyperplasia. However, atypical presentations with GH excess in the absence of radiologically detectable pituitary lesions have been reported. Case presentation: We report the case of a 43-year-old male referred for progressive craniofacial deformity and excessive height. Clinical evaluation revealed features consistent with GH excess, including gigantism, frontal bossing, prognathism, and progressive respiratory and neurological complications. Imaging demonstrated extensive polyostotic fibrous dysplasia involving the craniofacial bones, thoracic cage, and spine, resulting in severe skeletal deformities and multisystem complications. Biochemical assessment confirmed GH excess with elevated insulin-like growth factor 1 levels and failure of GH suppression during an oral glucose tolerance test. Notably, pituitary magnetic resonance imaging was completely normal, with no evidence of adenoma or hyperplasia. Additional endocrine evaluation revealed hypogonadotropic hypogonadism and structural thyroid abnormalities without functional hyperthyroidism. Based on the constellation of clinical, biochemical, and imaging findings, a diagnosis of atypical McCune–Albright syndrome was established. The patient was managed medically with a long-acting somatostatin analog and multidisciplinary follow-up. Conclusion: This case highlights the marked phenotypic heterogeneity of McCune–Albright syndrome and underscores that growth hormone–mediated gigantism may occur despite a normal pituitary MRI. Recognition of such atypical presentations is crucial to avoid diagnostic delay and to guide appropriate management. A multidisciplinary approach remains essential for optimizing outcomes in patients with complex skeletal and endocrine involvement