Global Health Initiatives Research Articles

Shedding light on maternal mental health in LMICs: a cornerstone of maternal and child health care.

Maternal and Child Health (MCH) programs have long been integral to global public health initiatives, aiming to safeguard the well-being of both mothers and their offspring. However, amidst the comprehensive approach to physical health, the mental well-being of mothers has often been overlooked, representing a critical gap in these programs. This paper examines the importance of addressing maternal mental health within the framework of MCH programs, highlighting its significance and the repercussions of its neglect. Despite its profound impact on maternal and child outcomes, issues such as postpartum depression, anxiety, and maternal stress are frequently disregarded in MCH interventions. This oversight not only undermines the holistic nature of maternal health but also perpetuates cycles of poor mental health within families and communities. Herewith, an effort was made to highlight the importance of maternal mental health and the need to focus and strengthen awareness about it through policy and programs.

Prevention and Treatment of HIV/AIDS: The Gates Foundation’s Role in Reducing Incidence and Extending Lives

HIV/AIDS remains a critical global health challenge, with profound social and economic impacts exacerbating existing inequalities and straining healthcare systems. Since its inception, the Bill & Melinda Gates Foundation has been at the forefront of combating this epidemic through its comprehensive and strategic approach. This review examines the foundation’s role in reducing HIV incidence and extending lives by focusing on prevention and treatment strategies. The foundation’s key initiatives include advancing scientific research and innovation, expanding access to antiretroviral therapy (ART), supporting pre-exposure prophylaxis (PrEP), and integrating HIV care with other health services. The foundation also emphasizes policy advocacy and global leadership, collaborating with international organizations to shape health strategies and reduce stigma. The review highlights the impact of these efforts in high-burden regions, particularly sub-Saharan Africa, and explores emerging challenges such as drug resistance and health inequities. Future directions include embracing innovative solutions, expanding access to advanced prevention methods, and ensuring the sustainability of HIV/AIDS programs in resource-limited settings. The Gates Foundation’s multifaceted approach serves as a model for global health initiatives, demonstrating how strategic investment and collaboration can drive significant progress in the fight against HIV/AIDS. Keywords: HIV/AIDS, prevention strategies, treatment programs, antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP).

Simple, direct amplification of RNA-containing paper discs for diagnosing the hepatitis C virus.

Nucleic acid extraction (NAE) is crucial for molecular diagnostics but presents challenges in point-of-care testing (POCT) and decentralized settings. We developed a streamlined, paper-based NAE method for hepatitis C virus (HCV) RNA amplification, suitable for integration into POCT and lab-on-a-chip systems. This method uses Fusion 5 paper discs, completing extraction in under 30 min without centrifugation. The nucleic acids on the disc can be directly used or eluted for amplification. We validated this method's compatibility with reverse transcription-polymerase chain reaction (RT-PCR), real-time quantitative PCR (RQ-PCR), and loop-mediated isothermal amplification (LAMP), demonstrating versatility across amplification platforms. Clinical evaluation (n = 60) showed 100% sensitivity and specificity with a low detection limit of ~101 IU/mL. Results matched those from standard HCV RQ-PCR, confirming accuracy. Additionally, incorporating polyethylene glycol (PEG) improves extraction efficiency, eliminating the need for ethanol treatment and washing/drying steps. This modification enhances performance and suitability for field applications. Our paper-based HCV amplification is affordable and user-friendly, making it valuable for decentralized HCV detection and supporting global health initiatives.

Early assessment of vision-related quality of life predicts long-term spectacle-wear compliance

Non-compliance with spectacle wear undermines global health initiatives aimed at eliminating uncorrected refractive error—a preventable cause of visual impairment—by providing free or affordable spectacles to underserved populations. Non-compliance, however, is often identified too late, delaying effective health promotion strategies. This study evaluates the association between early-assessed vision-related quality of life (QoL) following spectacle correction and long-term compliance in adults. A comprehensive eye examination was conducted on 3052 university students to identify those visually impaired (presenting acuity ≥ Snellen 6/12 in the better eye) due to uncorrected refractive error. After refractive correction, participants achieving a best-corrected visual acuity of Snellen 6/6 completed the National Eye Institute 25-item Visual Function Questionnaire (NEI-VFQ-25) at baseline and within the first week of correction. A 6-month follow-up assessed compliance with spectacle wear. The average baseline NEI-VFQ-25 score improved from 67.35 (± 13.53%) to 90.56 (± 8.45%) with spectacle correction (P < 0.001) in the first week, with individual changes ranging from 2 to 70%. After 6 months, only 54 (47%) out of the 115 eligible participants (58 females; ages 18 to 29) were compliant. Following the adjustment for covariates, the results revealed that gains in NEI-VFQ-25 score below 40 were significantly associated with reduced compliance over the 6-month period (OR: 0.39, 95% CI: 0.06–0.99, P = 0.047). This supports an association between early vision-related QoL and long-term compliance. Scheduling a short follow-up to assess vision-related QoL within the first week after dispensing spectacles may help identify potential non-compliant wearers early, allowing for timely interventions.

Pediatric Trauma - A Silent Epidemic.

Trauma is the leading cause of preventable deaths in children all over the world. In the majority of cases, children are innocent victims of road traffic accidents. They suffer from both short-term and long-term impacts of trauma. Deaths from road traffic accidents can be prevented by adopting simple road safety measures and the use of protective equipment. Worldwide programs have been initiated to curb this ever-rising menace; however, the success of these programs depends on their outreach and acceptance among the population in general. Golden hours in trauma management is the initial hour post-trauma, the success of resuscitation depends on the appropriate management of pediatric trauma victims in hospitals dedicated to the management of pediatric trauma victims. The current review highlights the epidemiology, pattern of injury, road safety measures, and global health initiatives for the prevention of accident-related injury in children. The shortcomings of this review are as follows- Firstly pediatric trauma is an exhaustive topic, it is impossible to cover all aspects of pediatric trauma. Thus, the review might have missed some important aspects of pediatric trauma. Secondly, the concept of a pediatric trauma registry is nonexistent in almost all developing countries; hence a true picture of pediatric trauma epidemiology and injury patterns is missing. Thirdly not much work has been done on pediatric trauma in developing countries leading to insufficient data from these countries.

India’s Vaccine Diplomacy and Global Health Governance: A Soft Power Approach in the Context of Public Policy and Religious Values

Research Problem: India's vaccine diplomacy during the Covid-19 pandemic has not only emerged as a significant tool of soft power but also involves moral and ethical dimensions closely tied to religious values and public policy. In the midst of a global crisis, the interaction between India’s vaccine diplomacy and the religious and public policy frameworks of recipient nations requires deeper exploration. Research purposes: This article aims to analyze the role of India’s vaccine diplomacy in relation to public policy and religious values in recipient countries, examining how India’s global health initiatives influence moral and ethical perceptions of vaccine distribution, fairness, and international solidarity. Research methods: The study employs policy analysis through a comprehensive literature review, focusing on the relationship between vaccine diplomacy, public policy, and responses from religious communities in the recipient countries. It also explores the ethical and spiritual dimensions of India’s health diplomacy approach and its impact on public health policies. Results and Discussion: The findings reveal that India’s vaccine diplomacy, through initiatives like "Vaccine Maitri," not only strengthens political ties with neighboring and global countries but also interacts with religious value systems, influencing public acceptance of vaccines. Moral values such as solidarity and justice, integral to many religious traditions, reinforce positive responses to the vaccine initiatives. Additionally, in some nations, religious communities have played a significant role in promoting vaccine acceptance by framing the health response in moral terms. Research Implications and Contributions: This research highlights the importance of integrating religious values into public health policy, particularly in global health contexts. Vaccine diplomacy rooted in moral solidarity and universal ethical principles, aligned with religious values, has the potential to enhance international cooperation and reduce vaccine hesitancy. Thus, this study contributes to understanding how religion and public policy can collaborate effectively in addressing global health challenges.

Combating antimicrobial resistance: A framework for educational tool innovation

Abstract Issue The World Health Organization (WHO) stresses the need for educational and training initiatives to address antimicrobial resistance (AMR) across human, animal, and agricultural sectors. AMR, a growing public health threat, was responsible for approximately 4.95 million deaths in 2019. Traditional educational frameworks tackling AMR are often applied in isolated sectors, failing to incorporate a holistic or collaborative approach. Description of the Policy The Holistic Engagement and Adaptive Response Theoretical framework (HEARTf) proposes a comprehensive, innovative approach combining behavioral theories, and persuasive technology, including the Theory of Planned Behavior, Persuasive Technology, and Diffusion of Innovation. The framework is designed to integrate stakeholders in developing and accessing educational tools, specifically a game designed to teach students about AMR. HEARTf emphasizes a multidisciplinary methodology, beginning with Phase 1 (exploratory phase) to gather baseline information from potential prescribers in Norway and Zambia. Results Initial application of HEARTf is leading the development of an educational game on AMR. This game uniquely combines behavioral theories and digital design, focusing on high-impact areas of AMR. Preliminary feedback indicates enhanced stakeholder engagement and a heightened willingness to adopt AMR best practices across different sectors. Lessons The HEARTf approach demonstrates the potential for enhancing AMR education through innovative, theory-based game design and development. It advocates for the continued integration of comprehensive educational strategies into global health initiatives to combat AMR effectively. These actions, being tailored to diverse sectors, suggest that similar holistic, theory-driven approaches may be beneficial in other public health crises. Key messages • HEARTf fosters innovative, multidisciplinary AMR education, enhancing stakeholder engagement and adoption of best practices. • Theory-based educational tools in AMR developed using HEARTf can significantly impact global health strategies and should be integrated into broader public health efforts.

Gender differentials in cognitive frailty among older adults in India: a multivariate decomposition approach.

There has been an increasing focus on the interplay between physical frailty and cognitive impairment, as both conditions pose significant risks for life-threatening health complications and are receiving considerable attention in global geriatric health initiatives. A recent consensus introduces "cognitive frailty," denoting the co-existence of physical frailty and cognitive impairment without dementia. This study aims to ascertain the prevalence of cognitive frailty and investigate the factors contributing to gender differentials of cognitive frailty among older adults in India. This study has used the data from the nationally representative survey Longitudinal Ageing Study in India 2017-18. This study included a sample of 13,946 males and 14,989 females aged 60 and above. Descriptive and bivariate analyses were conducted. A proportion test was employed to assess gender disparities and determine the statistical significance of risk factors. Furthermore, multivariate decomposition analysis was performed to identify the extent to which various covariates contribute to explaining the gender differences observed in cognitive frailty. The overall prevalence of cognitive frailty was 4.4%. There was a significant gender difference in cognitive frailty among older adults in India (Difference: 4.3%; p-value < 0.001] with 2.1% (95% CI: 1.8-2.3) older males and 6.4% (95% CI: 6.0-6.8) older females suffering from cognitive frailty. The considerable gender gap in cognitive frailty would be reduced if women had similar levels of education (37% reduction) than men. Results highlight that increasing age, being a woman (AOR: 1.61; 95% CI: 1.33-1.95), out-of-wedlock, less education and non-working status (AOR:2.19; 95% CI: 1.71-2.80) were significantly associated with cognitive frailty. Poor nutritional status, and depression are also prone among the cognitively frail participants. Gender sensitive interventions improving education access for women are crucial. Developing countries like India urgently require a multidimensional approach to ensure appropriate and comprehensive healthcare for the elderly population.

Low availability of haematin (hemin) in Pakistan.

Madam, Acute Intermittent Porphyria (AIP) is an autosomal dominant disorder that results from a defect in the enzyme named porphobilinogen deaminase.1 It is symptomatic porphyria, involving the accumulation of porphyrins and porphyrin precursors due to impaired conversion in haeme synthesis. Acute Intermittent Porphyria is clinically characterized by acute episodes of multiple gastrointestinal and neurologic symptoms; during which the patient remains healthy between episodes.2 Acute Intermittent Porphyria episodes are commonly observed in post pubertal females. The most common symptoms include periodic abdominal pain, vomiting and hypertension followed by neurologic damage that leads to peripheral and autonomic neuropathies (mostly motor) and psychiatric manifestations.2 Hormonal cycle regulation may worsen porphyria, since its symptoms coincide with the menstrual cycle. Although positive response has been noted in hormonal suppression by gonadotropin releasing hormone agonists.3 Currently, the most widely used treatment is hemin, a form of haeme that can be given intravenously. Its administration reduces the haeme deficit, hence limits the production of porphyrins precursors by the body. Availability of hemin in Pakistan is not promising while alternatives such as intravenous infusion of glucose, and pain relievers like Nalbuphine, a man-made opioid analgesic, and Morphine are short-term treatments. Haeme Arginate (HA), a compound of haeme and arginine, is equivalent to hematin in the treatment of AIP. Long-term weekly intravenous infusions of prophylactic HA prevent severity and frequency of porphyric attacks in patients with AIP.4 While haeme therapy is recommended if a patient exhibits neurological impairment, liver transplant appears to be the last resort in patients with recurrent clinical manifestations. To effectively mediate the growing need of Hemin in Pakistan, a systematic plan with effective and immediate steps must be introduced. The regulatory authorities must expedite the approval and licensing process of appropriate medication that would meet the growing need of the country, while not compromising on its quality. The possibility of local production should be explored, while strengthening international ties aimed at importing affordable medication. The government should focus on initiating partnerships with international organizations, non-governmental organizations (NGOs) and global health initiatives. Nationwide workshops and informative campaigns towards healthcare work should be a priority, to raise awareness of the situation and the proper steps that should be taken to minimize its adverse effects. Empowering patient advocacy groups would be beneficial in recognizing any shortcomings of the plan and to divert resources accordingly.

From Hong Kong to the UK: A Community and Public Health Nursing Researcher's Reflections on an International Fellowship.

Our globalized world means that most public health challenges cannot be tackled alone; they require unified and collaborative working across countries. Overseas fellowships offer an immersive experience that empowers nursing researchers to enhance global collaborations and synergize diverse research expertise from various cultural contexts. This enriched collaboration leads to more innovative solutions to public health issues and significantly enhances the overall impact of their research. This paper presents a self-reflection from the perspective of a community and public health nursing researcher, based in Hong Kong. During a 2-month research secondment at a university in the UK, I explored ways to leverage my fellowship to strengthen global connections, expand collaborations, and enhance my research capabilities in addressing health equity issues among LGBTQ+ populations, particularly concerning sexual violence. By sharing my journey, I aim to inspire more nursing researchers to engage with global academic communities and collectively advance global public health initiatives.

B-215 Evaluating RT-qPCR for Dengue Virus Detection: Outcomes of a Brazilian External Quality Assessment Program

Abstract Background Dengue virus (DENV), responsible for a prevalent arthropod-borne viral illness, poses a substantial public health challenge worldwide. Clinically, DENV's manifestation often resembles that of other arboviruses, resulting in frequent healthcare visits and complicating the early diagnosis, which is critical for patient management. While virus isolation is a viable method, RT-qPCR assays yield significantly quicker results. Rapid immunochromatographic tests are available; yet, RT-qPCR not only matches their sensitivity but also provides distinct advantages in clinical laboratory settings. These include higher throughput and integrated, traceable quality control within each routine, offering less subjective and more dependable results. Maintaining high diagnostic standards for DENV is imperative. External quality assessment programs (EQAP) play a key role in enhancing laboratory diagnostic capabilities by monitoring and assessing diagnostic methods. This study evaluates the diagnostic efficacy of RT-qPCR for DENV using data from an EQAP conducted by a Brazilian provider, accredited by ABNT NBR ISO/IEC 17043:2011. Methods The quality control samples comprised lyophilized suspensions containing viable DENV particles, grown on vero cells (BCRJ 0245/ATCC CCL-81) under BSL-3 conditions. From February 2017 to November 2022, twenty-four EQAP survey rounds were carried out, each encompassing three samples, culminating in 1,153 data points. The evaluation metrics included participant numbers, adequacy percentage, sensitivity, specificity, and the incidence of false positives and negatives. The Mann-Kendall test assessed trends in these metrics over the survey rounds. The RT-qPCR kits employed by participants were classified either as in-vitro diagnostic (IVD) or as laboratory-developed tests (LDT). Kits that demonstrated high performance in terms of adequacy, sensitivity, and specificity were identified and listed. Results The number of laboratories participating has increased. Starting with four in 2017, the program expanded to 28 by 2022. Laboratory accuracy was high during the evaluation period, with a median of 99% (97.8% in 2017 and 99.2% in 2022). The Mann-Kendall test indicated a significant trend of increased accuracy (p&amp;lt;0.001). Specificity remained stable at 98.8%, while sensitivity improved, with a median of 99.4%—rising from 93.3% in 2017 to 100% in 2022 (p&amp;lt;0.001). Only three false negatives were reported over three separate rounds, and six false positives were reported across four rounds. Both LDT and IVD RT-qPCR kits demonstrated high accuracy (99.4% and 98.4%, respectively). Biomanguinhos ZDC, Viasure ZDC, and ZDC Multiplex kits all showed 100% adequacy, sensitivity, and specificity. Conclusions This study highlights the increasing adoption of RT-qPCR for DENV detection, as evidenced by the growing number of laboratories in the EQAP program and the consistently high adequacy rates from 2017 to 2022. Nonetheless, the number of participating laboratories remains relatively small for a vast tropical country like Brazil. The high sensitivity and specificity, along with the infrequency of false results, underscore its effectiveness. The superior performance of certain kits suggests possible advancements in DENV diagnosis, contributing to global public health initiatives against this arboviral disease.

Climate Change and Vector-Borne Diseases: A Scoping Review on the Ecological and Public Health Impacts

Climate change is increasingly recognized as a significant driver of ecological and public health changes, particularly concerning vectorborne diseases. This scoping review aims to systematically map the current research on the impact of climate change on vector ecology and the subsequent effects on disease transmission dynamics. We conducted a comprehensive literature review across multiple databases to identify critical vectors, such as mosquitoes, ticks, and fleas. We examined how climate variables like temperature, precipitation, and humidity affect their populations, behaviors, and life cycles. Additionally, we explored the shifting geographic distributions of these vectors, investigating how climate change influences their spread and the emergence of diseases such as malaria, dengue, and Lyme disease in new regions. The review highlights the complex and multifaceted interactions between climate change and vector-borne diseases, emphasizing the necessity of understanding these relationships to inform effective public health strategies. Our findings indicate considerable variability in the impacts of climate change across different regions and vector species, underscoring the need for localized studies and tailored interventions. Moreover, significant research gaps were identified, particularly in predictive modeling, long-term surveillance, and the socio-economic impacts of vector-borne diseases exacerbated by climate change. We suggest directions for future research, including the development of integrated climate-health models and enhanced disease surveillance systems, to better anticipate and mitigate the effects of climate change on vector-borne disease transmission. This review underscores the urgency of addressing climate change as a critical component of global health initiatives and the importance of interdisciplinary approaches in tackling this complex issue. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 915-933

Influences of Global Health Initiatives in Plastic and Reconstructive Surgical Residents

Purpose: Over the last decade there is an increased awareness that the need for surgical care in under-resourced countries is contributing to significant health inequities and financial hardship across the globe. Plastic surgery has long been recognized as a surgical discipline that has been successful in deploying resources to help address these inequities but to be sustainable there must be a lasting commitment through teaching and education. The purpose of this study is to answer the question “In plastic and reconstructive surgical residents, how does participation in global health initiatives influence independent clinical practice and their perceptions of global health?” Methods: A survey was administered through Redcap to 59 total eligible current or previous Wake Forest School of Medicine plastic and reconstructive surgical residents. Results: About 33 out of 34 participants have had some kind of global health exposure with the majority being through mission trips, volunteering, and external rotations. There was a 33.3% improvement in awareness of global surgical disease burden ( P = .000093 &lt; .05), 23.5% improvement in obligations to create global change ( P = .00021 &lt; .05), 26.3% improvement in comfortability with language and cultural barriers ( P = .0013 &lt; .05), and 20.9% improvement in doctor-patient relationships with patients of differing backgrounds ( P = .0019 &lt; .05) when comparing participant’s views prior and after residency training. Overall, participants were inclined to continue with global health initiatives in the future as 75.8% see themselves participating in another global health experience and 90.9% believed participating in global health has an impact on independent clinical practice and professional development post-residency. Conclusions: Global health initiatives within surgical residency curriculums have had tremendous effects on the perceptions of global health amongst plastic and reconstructive surgical residents, which may improve physician shortage and global health needs in the future.

The Role of Social Determinants in Alcohol Consumption and Cardiovascular Health: The Pathways Study

Background and AimsThe "J"-shaped relationship between alcohol consumption and cardiovascular health is recognized as potentially influenced by residual confounders, and this study aimed to clarify the role that social determinants play in the relationship. Methods and ResultsUsing NHANES data from 2005-2018, this study analyzed 30,648 participants to assess how eight social determinants (employment, income, food security, education, healthcare access, insurance, housing stability, and marital status) influence the relationship between alcohol consumption and cardiovascular disease (CVD). Moderate drinking reduces CVD risk (HR: 0.741, 95%CI: 0.661, 0.831, P<0.001), while heavy drinking increases it (HR: 1.025, 95%CI: 1.004, 1.095, P=0.035). Structural equation modeling revealed that ideal social determinants and health metrics contribute significantly to the cardiovascular protective effects of moderate drinking (path proportion: 42.31%). Conversely, heavy drinking is associated with poorer social determinants and health metrics, masking the cardiovascular protective effect (path proportion: -90.91%). ConclusionsThis study quantifies the role of social and health factors in the relationship between alcohol consumption and CVD. Despite identifying direct cardiovascular protective effects of alcohol consumption, global health initiatives should continue to advocate for reduced heavy drinking, given the significant risks involved.

The Vaccine Godmother: Dr. Gagandeep Kang's Pioneering Journey in Global Health and Vaccine Development.

Dr. Gagandeep Kang is a distinguished Indian microbiologist and virologist known for her pioneering work in the study of gastrointestinal diseases, diarrheal infections, and vaccine development. This article highlights her career, beginning with her medical education at Christian Medical College (CMC) Vellore, where she embarked on her groundbreaking research in enteric diseases, particularly rotavirus, a major cause of child mortality globally. Over the course of her distinguished career, she has led groundbreaking research on rotavirus, contributing to the development of two WHO-approved vaccines tailored for Indian communities: Rotavac (Bharat Biotech, Hyderabad, India) and Rotasiil (Serum Institute of India, Pune, India). Beyond her research, Dr. Kang has held significant advisory roles on national and global platforms, including WHO's Global Advisory Committee on Vaccine Safety and the Coalition for Epidemic Preparedness Innovations (CEPI). She has authored over 300 scientific publications and coauthored the bestselling book "Till We Win,"which details India's fight against the COVID-19 pandemic. Her exceptional contributions have earned her numerous accolades, including the Infosys Prize in Life Sciences, the Fellowship of the Royal Society, and the Canada Gairdner Global Health Award. Dr. Kang's career exemplifies her dedication to advancing public health, vaccine development, and global health initiatives, making her a trailblazer in the field of microbiology and virology.

Health Education for Sustainable E-Waste Management

A combination of ever-increasing device usage and lightning-fast technological advancements has led to a critical problem: electronic waste. One technique to encourage people to dispose of their electronic waste in a more sustainable fashion is to raise their level of green literacy. Using a literature review approach, this study examines green literacy programs as they pertain to e-waste management. After that, it evaluates the programs' effectiveness and makes recommendations for further developments. This publication uses a thorough literature review technique as its research method. The scholarly sources used were journals, academic books, research reports, and policy documents. The selection of sources was based on their relevance, credibility, and contribution to understanding key themes related to green literacy, public health education, and behavior change in e-waste management practices. Additionally, the analysis focused on the intersection between educational interventions, awareness campaigns and global health initiatives, especially those targeting vulnerable populations such as children and pregnant women. The findings demonstrate that while green literacy can raise public knowledge and comprehension of the significance of responsible e-waste management, there are still obstacles to its widespread adoption. By using social media, communities, and educational institutions, green literacy has the potential to raise awareness about the risks of e-waste and the significance of recycling. However, challenges such as public apathy and limited access to recycling facilities continue to impede the implementation of green literacy. The community, along with the governmental and private sectors, must work together to address these issues and encourage the sustainable disposal of electronic trash. Ongoing education and awareness efforts utilizing many communication platforms, including social media, the media, and educational programs in communities and schools, are necessary to improve e-waste management. In order to create easily accessible recycling facilities and launch programs that reach different societal levels, the government must collaborate with the commercial sector and non-governmental organizations.

Cannabinoids from C. sativa L.: Systematic Review on Potential Pharmacological Effects against Infectious Diseases Downstream and Multidrug-Resistant Pathogens

Cannabis sativa L. has garnered attention as a potential source for new antimicrobial agents, particularly due to the increased prevalence of microbial resistance to conventional antimicrobials and the emergence of multidrug-resistant pathogens. This review, conducted according to the PRISMA 2020 statement, systematically analyzed the antimicrobial properties of C. sativa extracts and cannabinoids against various bacteria, fungi, viruses, and parasites. Data were collected from the scientific literature (102 papers) and clinical trials (5 studies) from 2014 to June 2024. Findings revealed that cannabinoids, especially CBD, demonstrate significant antimicrobial activity against Gram-positive bacteria like MRSA, Gram-negative bacteria such as Pseudomonas aeruginosa, various Candida species, SARS-CoV-2, and HIV. Additionally, CBD showed efficacy against parasitic infections like Echinococcus granulosus and Leishmania species. These results suggest that cannabinoids may represent a new class of antimicrobial agents with unique and diverse mechanisms of action, potentially effective in broad-spectrum therapies. This study highlights the urgent need for further research and standardized clinical trials to validate these findings and to develop cannabinoid-based treatments. The antimicrobial properties of C. sativa align with WHO priorities and support global health initiatives, offering promising avenues for addressing antimicrobial resistance and improving public health outcomes.

Comparison of In-person VS remote learning modalities for ultrasound-guided knee arthrocentesis training using formalin-embalmed cadavers

ObjectivesThis study aims to compare the efficacy of remote versus in-person training strategies to teach ultrasound guided knee arthrocentesis using formalin embalmed cadavers.Methods30 first-year medical student participants were randomly assigned to remote or in-person training groups. Pre- and post- training surveys were used to evaluate participant’s self-confidence in their ability to perform the procedure. Participants were asked to watch a 30-minute training video and then attend a skills training workshop. The workshops consisted of 20 min of hands-on instruction followed by a skills assessment.ResultsFollowing training, participant self-confidence increased significantly across all survey items in both groups (p = 0.0001). No significant changes in participant self-confidence were detected between the groups. Skills and knowledge-related metrics did not differ significantly between the groups with the exception of the “knowledge of instruments” variable.ConclusionsOur data suggests that remote ultrasound-guided procedure training, although logistically complex, is a viable alternative to traditional in-person learning techniques even for a notoriously hands on skill like ultrasound guided knee arthrocentesis. Novice first-year medical student operators in the remote-training group were able to significantly increase their confidence and demonstrate competency in a manner statistically indistinguishable from those trained in-person. These results support the pedagogical validity of using remote training to teach ultrasound guided procedures which could have implications in rural and global health initiatives where educational resources are more limited.

Evaluating Parental Knowledge and Behaviors Regarding Developmental Toxicants in Jazan, Saudi Arabia Using the Prevention of Toxic Chemicals in the Environment for Children Tool (PRoTECT).

This study evaluated the level of knowledge among parents in Jazan, Saudi Arabia, regarding substances that can harm child development. The Prevention of Toxic Chemicals in the Environment for Children Tool (PRoTECT) was used for this assessment. A cross-sectional survey using a multi-stage cluster random sampling approach was undertaken among 424 parents who were enlisted from eight primary healthcare centers (PHCCs). The PRoTECT score's median value was 72 out of 90, suggesting a generally high level of awareness. The study found that individuals with higher education, particularly those with postgraduate degrees, had greater awareness of protecting their children's health. Interestingly, unemployed individuals and those residing in mountainous areas also demonstrated higher awareness, possibly due to having more time to focus on their children's health and well-being. Most participants (68.2%) acknowledged the correlation between exposure to toxic chemicals during pregnancy and early childhood, and the subsequent development of neurodevelopmental disorders. The study found a solid foundation of knowledge, with 85.1% of participants interested in learning more about reducing children's exposure, but it also stressed the need for specific actions to turn awareness into prevention. These findings would help policymakers develop effective strategies, such as targeted educational campaigns, collaboration with healthcare providers, utilization of media channels, and encouragement of community-led initiatives, to reduce children's exposure to developmental toxicants in line with national and global environmental health initiatives. Future research should focus on longitudinal consciousness and behavior evaluations and regional environmental contaminants.

Ruptured AAA: bridging the gap between international guidelines and local clinical realities

BackgroundTreatment of asymptomatic Abdominal Aortic Aneurysms (AAA) presents a clinical challenge, requiring a delicate balance between rupture risk, patient comorbidities, and intervention-related complications. International guidelines recommend intervention for specific AAA size thresholds, but these are based on historical trials with limited female representation. We aimed to analyse disease characteristics, AAA size at rupture, and intervention outcomes in patients with ruptured AAA from 2009 to 2023 to investigate the gap between guidelines and local realities.MethodsThis single-centre retrospective cohort study analysed electronic health records of patients treated for a ruptured AAA, excluding those who were managed palliatively. The study assessed patients’ demographics, risk factors, comorbidities, clinical presentation, radiological characteristics, and outcomes.ResultsOf 164 patients (41 females, 123 males, median age 73.5), 93.3% presented with abdominal or back pain. The median AAA size at rupture was 8.0 cm in males and 7.6 cm in females. No significant correlations were found between demographic characteristics, risk factors, AAA size, repair modality, and outcomes. Trends show a decline in AAA prevalence and rupture rates, aligning with global health initiatives. Post-intervention survival rates at 30 days were 70.7% (67.5% in males and 80.0% in females), and at 2 years were 65.85% (61.7% in males and 70.0% in females).ConclusionEvolving AAA trends and improved post-intervention survival rates warrant a critical reassessment of existing intervention recommendations. Adjusting intervention thresholds to larger sizes may be justified to optimise the risk-benefit ratio.