Outbreaks of Emerging and Re-Emerging Infections and Their Management in Healthcare Settings.

The endemic spread of carbapenem-resistant organisms (CROs) is often driven by inadequate prevention of patient-to-patient transmission. This study evaluates the impact of rapid molecular surveillance on in-hospital CRO spread, invasive infections, and costs. In this retrospective, single-center study (Jan 2017-Dec 2023), adult patients at IRCCS Humanitas Research Hospital underwent CRO simultaneous screening using PCR (Xpert™ Carba-R) and culture (Brilliance™ CRE Agar) on admission, with weekly follow-ups in ICUs and onco-hematology wards. Upon PCR result availability, patients were isolated/cohorted. Bloodstream infections (BSIs) were defined by positive blood cultures. Cox regression estimated the risk of incident BSIs. In parallel an economic analysis of the two methods was conducted to asses their impact on resources. Among 21,525 samples, PCR and culture showed high concordance (Cohen's Kappa: 0.909, 95% CI: 0.89-0.93). PCR excluded CRO colonization with 99.7% specificity (95% CI: 99.61-99.76) and a negative likelihood ratio of 0.02. Negative PCR results were available in a median of 2.6h versus 50h for culture (p < 0.001), reducing isolation time and adding ~ 10 bed-days annually in our two-bed setup. PCR sensitivity for culture-proven colonization was 97.7% (95% CI: 96.2-99.18). K. pneumoniae accounted for 88% of isolates, with blaKPC as the predominant gene, followed by blaVIM (32.1% culture-negative). CRO acquisition rates were low in ICUs (1.3/1000 person-days) and onco-hematology wards (0.32/1000 person-days). CRO-BSIs occurred in 75 patients after a median of 12 days, with incidences of 2.35/1000 person-days in colonized versus 0.17/1000 in non-colonized patients. Cox regression identified acquired CRO colonization (aHR = 8.11, 95% CI: 2.38-27.61) and pre-existing blaNDM colonization (aHR = 6.23, 95% CI: 1.05-36.99) as independent predictors of CRO-BSI. The short turnaround times of molecular approach allows to free up beds, increasing the number of patient treatable each years. PCR screening is highly concordant with culture, while delivering faster results with positive impacts on isolation time, bed availability, and rapid identification of patients at high risk for CRO-BSIs. From an economic perspective, the molecular approach leads to an optimization of scarce and precious resources.

Anaemia in pregnancy is a global public health concern, especially in low and middle-income countries, where it is linked to adverse maternal and neonatal outcomes. Despite various antenatal care interventions to prevent anaemia in pregnancy, a considerable proportion of pregnant women still present with anaemia at delivery. This study aimed to determine the prevalence, severity, and factors associated with pre-delivery anaemia among women at Kyangwali Health Centre IV (KHCIV). A health facility-based cross-sectional analytical study was conducted. A simple random sampling technique was used to select 422 pregnant mothers at ≥ 28 weeks of gestation admitted for delivery. Data on socio-demographic, medical, and obstetric characteristics were collected using an interviewer-administered semi-structured questionnaire and analyzed using STATA version 15. Anaemia was defined as a hemoglobin (Hb) level less than 11g/dl. We performed a modified Poisson regression analysis to determine the factors associated with pre-delivery anaemia at a 95% confidence level and 5% statistical significance using multivariable analysis. The overall prevalence of pre-delivery anaemia was 30.1% (95% CI, 29.90-30.27%). The prevalence of mild, moderate, and severe anaemia was 71.7%, 22.8%, and 5.5%, respectively. Attendance of more than four Antenatal Care (ANC) visits (APR = 0.42, 95% CI: 0.24-0.73, p = 0.003), malaria prevention with Fansidar (APR = 0.16, 95% CI: 0.04-0.54, p = 0.004), and prior use of contraceptives (APR = 0.50, 95% CI: 0.34-0.74, p < 0.001) were associated with a lower prevalence of pre-delivery anaemia. On the contrary, treatment for malaria during pregnancy was associated with a higher prevalence of pre-delivery anaemia (APR = 1.53, 95% CI: 1.08-2.46, p < 0.015). Anaemia remains a significant maternal health burden. A third of the pregnant women admitted for delivery in Kyangwali HCIV had pre-delivery anaemia, albeit the majority had mild anaemia. The findings highlight the protective role of ANC attendance and use of antimalarial chemoprevention during pregnancy, and prior contraceptive use in reducing the risk of anaemia. However, a history of malaria treatment during pregnancy was associated with increased anaemia, suggestive of inadequate prevention, underscoring the need for additional malaria preventive strategies. Strengthening ANC services to ensure uptake of a comprehensive package of preventive interventions may help reduce the prevalence of pre-delivery anaemia.

Introduction: Lassa fever remains a serious public health threat in Nigeria, with annual outbreaks affecting healthcare workers due to inadequate Infection Prevention and Control (IPC) measures. As of March 2024, the country had reported 806 confirmed cases and 150 deaths, including 32 infections among healthcare workers. An outbreak at a Nigerian military hospital resulted in four deaths, three of whom were healthcare workers. In response, a multidisciplinary emergency team from the Irrua Specialist Teaching Hospital (ISTH) was deployed to assess existing IPC facilities and implement rapid IPC interventions. Method: A targeted intervention was conducted from 27th February to 29th March 2024. IPC facilities and practices within the isolation ward were assessed using a checklist adapted from the World Health Organisation 2017 IPC Assessment Framework and the Nigeria Centre for Disease Control and Prevention Guidelines on infection prevention and control for viral haemorrhagic fevers. Structural modifications were undertaken to reduce transmission risks and facilitate effective barrier nursing. Comprehensive training sessions were provided to staff, focusing on Lassa fever transmission, hand hygiene, appropriate use of personal protective equipment, environmental disinfection, waste disposal and chlorine preparation. Result: Initial assessment revealed that the isolation ward scored 39.0%, which improved to 73.5% post-intervention. Key improvements included the demarcation of high and low risk zones, the establishment of donning and doffing areas, and the installation of hand hygiene stations at strategic points. Three confirmed cases were admitted, treated with intravenous ribavirin and supportive care, and subsequently discharged without further deaths. No additional health worker infections occurred. Conclusion: The IPC intervention implemented was associated with a reduction in the risk of hospital-based transmission of Lassa fever at the Military hospital. Sustained investment in IPC infrastructure and personnel training is essential in ensuring effective responses to future outbreaks.

This exploratory survey study aimed to evaluate the epidemiology, treatment patterns (including pharmacotherapy, rehabilitation, and supportive care), economic burden, drug preferences, and unmet needs of Chinese SMA patients. We conducted an anonymous online survey using a self-developed questionnaire from March 4 to March 31, 2024. The questionnaire collected comprehensive data on epidemiology, treatment patterns, rehabilitative interventions, nursing management, economic burden, and preferences. Data analysis was performed using descriptive statistics and chi-square tests. Analysis of 82 valid questionnaires revealed that 91.5% of SMA patients had type I or II disease, with 69.5% diagnosed by genetic testing within 12 months of birth. Awareness of prenatal screening was low. Nusinersen and Risdiplam showed comparable utilization rates and efficacy, though Risdiplam was associated with significantly higher rates of adverse events. Over 75% of caregivers reported financial constraints, with more than 42% expressing long-term affordability concerns. Rehabilitation participation reached 86.6%, predominantly involving motor function training, stretching therapy, and the use of assistive devices. Critical gaps included the finding that 89.0% of caregivers lacked formal training, 40.8% of patients lacking respiratory interventions, and a high demand for emergency skills training (61.0%). Treatment preferences prioritized oral administration, liquid formulations, and fruit flavors, with efficacy, affordability, and ease of use (80.5%) being the primary decision-driving factors. The management of SMA in China faces three primary challenges: inadequate prevention awareness, critical caregiving deficiencies, and prohibitively high treatment costs. Urgent actions include scaling up prenatal/newborn screening, establishing multidisciplinary care models to address respiratory/nutritional gaps, and implementing policy reforms to improve affordable drug access.

Forests, one of our most important natural resources, are under threat of decline and extinction due to factors such as increasing populations, expanding agricultural lands to meet needs, urbanization and industrialization. This study evaluates the use of unmanned aerial vehicles in detecting and preventing forest fires, which are increasing in frequency and intensity due to factors such as human activities, climate change and inadequate prevention and response. Furthermore, recommendations were developed based on the evaluation of data collected during unmanned aerial vehicles’ forest fire prevention missions. Research on forest fires and unmanned aerial vehicles have focused on topics such as mitigating the impacts of forest fires and developing forest firefighting strategies, highlighting the significant role that unmanned aerial vehicles play in these processes. One of the objectives of this study is to examine forest fires within the framework of crisis management and to contribute to the use of unmanned aerial vehicles in forest fires detection for crisis management purposes.

Pneumonia caused by the facultative intracellular pathogen Rhodococcus equi stands out as one of the most significant infections associated with a notably high mortality rate in foals worldwide. Limited therapeutic options and inadequate control and prevention measures result in substantial economic losses, underscoring the need for enhanced interventions. A cross-sectional, multi-province study was conducted on racehorse-breeding farms in Türkiye to estimate prevalence and index virulence, assess relatedness, and summarize antimicrobial susceptibility within a farm management context. Nasal and fecal swabs and environmental samples (soil and water) were cultured and confirmed; virulence was assessed with vapA-specific PCR, genetic relationship determined with PFGE, and antimicrobial susceptibility using disk diffusion. R. equi was detected in 10% of nasal swabs, 22.9% of fecal swabs, 29.4% of soil samples, and 5.9% of water samples; 46.2% of confirmed isolates were vapA-positive. Susceptibility patterns were favorable overall, with frequent ampicillin resistance, infrequent resistance to macrolides and rifampin, rare multidrug resistance, and no vancomycin resistance was detected. PFGE demonstrated substantial genotypic diversity, with 12 clusters and 29 distinct pulsotypes. Farm-level observations were exploratory. More frequent mechanical paddock cleaning coincided with the absence of foal deaths, and vapA-positive isolates were observed on farms with prior infection. Taken together, these findings support routine paddock hygiene, prompt isolation of clinically affected foals, culture-guided therapy, and continued surveillance, and they indicate a need for longitudinal and genomic studies to evaluate the impact.

BackgroundBone metastasis occurs in 30–40% of patients with advanced non-small cell lung cancer (NSCLC), and denosumab combined with PD-1/PD-L1 inhibitors has emerged as a promising treatment strategy. However, the “algorithmic echo chamber” effect on short-video platforms may distort patient cognition and treatment decision-making.MethodsA cross-sectional study was conducted using a custom-developed web crawler to collect 1,369 videos from Bilibili, Douyin, and Xiaohongshu. A total of 402 videos were included after a three-tier keyword filtering process. An AI-based evaluation system built upon the doubao-seed-1.6 model was established, integrating three international standards—Global Quality Score (GQS), Journal of the American Medical Association (JAMA) benchmark criteria, and the modified DISCERN tool—to assess multidimensional information quality. Kruskal–Wallis tests and Spearman correlation analyses were performed to explore inter-platform differences and the relationship between information quality and user engagement metrics.ResultsOverall video quality was substantially below professional medical standards: the mean GQS was 2.84 ± 1.06 (56.8% of the full score), JAMA was 0.34 ± 0.57 (8.5%), and modified DISCERN was 1.55 ± 0.69 (31.0%). Significant quality differences were observed across platforms (p < 0.001, Cohen’s d = 0.6–0.8): Douyin ranked highest, followed by Xiaohongshu, with Bilibili lowest. Correlation between user engagement and content quality was extremely weak (R2 = 0.004, r = 0.062), indicating substantial decoupling—high engagement did not equate to high-quality content. Medical professionals accounted for only 25.6% of content creators, while patient-generated content reached 52.2%. Evidence-based treatment information comprised merely 20.0–26.7%, whereas misleading or inaccurate claims accounted for 6.7–13.3%.ConclusionFrom a behavioral and cognitive perspective, the low quality of immune-oncology information on short-video platforms, coupled with algorithm-driven amplification of high-engagement but low-quality content, may exacerbate cognitive bias, potentially increasing clinical safety risks such as insufficient hypocalcemia monitoring and inadequate MRONJ prevention. Establishing a professional governance and oversight system is urgently required.

Palembang, as a rapidly expanding culinary destination, faces increased vulnerability to food contamination, particularly in the Ampera Bridge culinary area where dense vendor activity, inadequate sanitation, and proximity to pollution sources create favorable conditions for vector proliferation. Flies function as mechanical vectors capable of transmitting pathogens to food, posing a substantial public health risk. This study aimed to analyze environmental factors associated with fly density among food vendors around the Ampera Bridge. An analytical observational study with a cross-sectional design was conducted in November 2024. Fly density was measured using the Ministry of Health’s fly grill method and categorized into low, medium, and high. Independent variables included food serving area condition, trash can condition, sink condition, location, fly prevention facilities, temperature, and humidity. A total of 103 vendors meeting the inclusion criteria were selected through purposive sampling. Univariat analysis showed that most vendors had poor serving areas, trash cans, and fly prevention facilities. Bivariate analysis indicated that only vendor location and preventive facilities were significantly associated with high fly density. Multivariate analysis further demonstrated that inadequate fly prevention facilities were the strongest predictor of high fly density, followed by vendor location. The study concludes that preventive facilities and vendor proximity to pollution sources are key determinants of fly density. Strengthening sanitation practices and improving environmental hygiene infrastructure are recommended to reduce fly density and mitigate foodborne disease risk.

Reducing new HIV infections is crucial. Sex workers continue to face disparities in both HIV infection rates and inadequate prevention care. Stigma, criminalization, and financial instability hinder access to vital HIV prevention methods, including Pre-exposure Prophylaxis (PrEP). Evidence-based, community-centered PrEP care may help address these issues. An evidence-based group PrEP care model, Centering PrEP (C-PrEP +), could empower communities and reduce healthcare burdens. This study explored care professionals' perspectives on barriers and facilitators of C-PrEP + for sex workers. Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, we aimed to develop a pilot implementation plan for C-PrEP + . Individual interviews were held with care professionals at a U.S. Midwestern Community Health Center serving sex workers. To reflect the diverse roles and backgrounds of participants, we interviewed 14 healthcare professionals, including care providers, patient navigators, and billing specialists. Guided by a semi-structured interview guide, we sought care providers' views on obstacles and enablers related to prescribing PrEP and implementing group PrEP care for sex workers. Using Dedoose, we used directed content analysis to systematically explore their perspectives about C-PrEP + using predefined constructs from the EPIS framework to guide coding and interpretation. Major themes included healthcare for sex workers, challenges in standard PrEP care, perceptions of Centering PrEP, and barriers and facilitators for implementing C-PrEP + . Participants viewed group PrEP care as a means to foster patient-centered approaches and strengthen community ties, while addressing the demands of care. Thoughtful integration of C-PrEP + into clinics may be a promising strategy to improve HIV prevention for sex workers.

Pertussis remains a major public health concern in low- and middle-income countries despite the availability of effective vaccines. In Ethiopia, recurrent outbreaks continue to occur, particularly in hard-to-reach rural settings. The aim of this study was to investigate a pertussis outbreak, identify associated risk factors, and evaluate the effectiveness of implemented interventions in Sayient Woreda, Northwest Ethiopia. An observational, community-based, unmatched case-control study with a house-to-house approach was conducted from October 25, 2018, to January 22, 2019. A total of 50 cases and 100 controls were selected using simple random sampling. Data were collected through face-to-face interviews using a pre-tested World Health Organization-adopted questionnaire. Data were cleaned, coded, and entered into Epi Info™ (version 7.2.1.0) and exported to SPSS (version 23) for analysis. Variables with a p < 0.05 with 95% confidence interval were considered independent risk factors for pertussis infection in multivariable logistic regression analysis. The overall attack rate was 3.1/1000 population. The age of the affected individuals ranged from 3 months to 28 years, with a median age of 10 years (Interquartile Range (IQR): 0.7-12). Females accounted for 56.6% of the reported cases. Following the implementation of cephalexin therapy and active case search, a substantial decline in incident cases was observed. Independent risk factors for pertussis infection were inadequate awareness on transmission mode (adjusted odds ratio = 1.61, 95% confidence interval: 1.33-9.54), inadequate prevention and control measures (adjusted odds ratio = 4.64, 95% confidence interval: 2.19-9.83), household contact with a confirmed case (adjusted odds ratio = 6.99, 95% confidence interval: 1.19-41.15), being unvaccinated (adjusted odds ratio = 3.62, 95% confidence interval: 1.97-5.50), and unknown vaccination status (adjusted odds ratio = 1.77, 95% confidence interval: 1.96-16.08). A substantial pertussis outbreak occurred in Sayient Woreda, predominantly affecting children and adolescents. Inadequate community awareness, close household contact, and incomplete or unknown vaccination status significantly contributed to transmission. Strengthening routine immunization and enhancing community awareness are important for preventing future outbreaks.

The health of the population is shaped by political, social and environmental conditions - referred to as contextual factors in this paper - which influence the risk of type 2 diabetes and other non-communicable diseases (NCD). The article provides an overview of selected indicators for this topic. The indicators were developed based on a literature review and a multi-stage selection process, considering their relevance for the prevention of diabetes and other NCD as well as the availability of data. Available nationwide data were used for operationalisation. Six indicators were agreed upon: tobacco control, the consumer price index, food taxation and prevention expenditure in the area of health policy measures, the at-risk-of-poverty rate in the area of employment and social affairs, and use of means of transport in the area of built and physical environment. The time trends for these indicators are integrated into the NCD Surveillance of the Robert Koch Institute (RKI) and are presented on the web portal of the federal health reporting. The results for all indicators point to inadequate prevention measures. Context indicators help to track changes over time in environmental determinants of health. As part of NCD Surveillance at the RKI, this topic will be continuously developed.

Youth drug abuse in Nigeria has emerged as both a public health crisis and a threat to national stability, with prevalence rates far above global averages. In Wukari Local Government Area (LGA) of Taraba State, empirical findings reveal that drug abuse among youths is closely linked to poverty, unemployment, inadequate prevention training, and the absence of a deliberate education policy aimed at curbing substance use. This paper philosophically and empirically interrogates these findings, situating them within John Dewey’s democratic education, Paulo Freire’s critical pedagogy, and Amartya Sen’s capability approach. Drawing on a mixedmethods study of 500 youths aged 15–29 in Wukari, the study found that over 40% reported lifetime use of psychoactive substances, often connected to violence and conflict. The paper advances an “ESD-Plus” (Education for Sustainable Development + Evidence-Based Prevention) model, proposing an integrative approach that combines school-based prevention, vocational capability-building, and community peace education. It concludes by recommending policy realignment between Nigeria’s National Drug Control Master Plan (2021–2025), the National Policy on Education (2013), and UNESCO’s ESD 2030 framework. Education, reconceptualized as liberation, habit-formation, and capability expansion, is presented as the most effective means of reclaiming the future for Wukari’s youth and beyond.

Zambia faces persistently high malaria morbidity and mortality rates, worsened by inadequate prevention and treatment resources, and high transmission. We aimed to assess the impact of three long-lasting insecticidal net (LLIN) distribution campaigns in four Zambian provinces from 2010 to 2021. We employed binomial regression and interrupted time series to analyze monthly malaria incidence across four provinces in Zambia (Eastern, Luapula, Northern and Northwestern) with a combined population of 5965257 within 1357 health facility catchment areas, utilizing data from the national Health Management Information System. We analyzed the association between LLIN distribution and trends in malaria incidence in terms of monthly cases confirmed by rapid diagnostic testing during January 2010-December 2021. There was a significant reduction in malaria incidence rates following LLIN distribution. Temporal trends and seasonal patterns also influenced malaria transmission. Results showed a statistically significant decline in monthly malaria incidence rates following implementation of LLIN distribution, attributable to the immediate protective effects of nets; the binomial regression model showed up to 35% reduction in seasonally adjusted malaria incidence (rate ratio: 0.65, 95% CI 0.50 to 0.85; p=0.002). Regular and timely replacement of nets is essential to maintain their protective benefits. This study highlights the key importance of LLINs for malaria control as part of wider strategies in Zambia and elsewhere.

ABSTRACTIntroduction:Elevated blood pressure is one of the commonly modifiable risk factors of cardiovascular diseases (CVDs). Inadequate prevention, diagnosis, and treatment of hypertension lead to increased cardiovascular complications in low- and middle-income countries such as India. We aimed to estimate the prevalence of undiagnosed hypertension and assess the associated cardiovascular risk among older adults in India.Methods:Data from Longitudinal Ageing Study in India (LASI), 2017-18 were utilized. We included 45991 participants aged ≥40 years who were not aware about their hypertension status. A multivariable regression model assessed the correlates of undiagnosed hypertension presented as adjusted odds ratio (AOR) with 95% CI. Cardiovascular risk assessment was done using World Health Organization/International Society of Hypertension (WHO/ISH) chart for South-East Asian Region D (SEAR-D).Results:The prevalence of undiagnosed hypertension was 12%. Undiagnosed hypertension was significantly associated with alcohol consumption [AOR: 1.58 (95% CI: 1.32–1.88)] and obesity [AOR: 1.77 (95% CI: 1.41–2.24)]. 36% of the undiagnosed individuals with hypertension had visited healthcare facility at least once in the past 12 months. We observed 43% of the undiagnosed Individuals with hypertension had the CVD risk of <10% as per WHO/ISH risk chart.Conclusion:A significant proportion of undiagnosed individuals with hypertension are at a risk of having CVD which cannot be overlooked. Primary care should be strengthened to increase the early diagnosis and treatment where the recent initiatives of upgraded Ayushman Arogya Mandir may play a major role. Additionally, primary care providers should not miss the opportunistic screening of patients visiting healthcare facilities.

WITHDRAWN: Inadequate prevention, detection and early management of PPH: organizational determinants

To address the imbalance and inadequacy in urban-rural regional development and advance the implementation of Guangdong Province’s High-Quality Development Project of Hundreds of Counties, Thousands of Towns, and Myriads of Villages, this study focuses on innovating the two-way flow mechanism of urban-rural factors and conducts systematic research integrating theoretical analysis and practical investigation. It first clarifies the theoretical logic of urban-rural factor flows, identifying that such flows cover both traditional factors (i.e., labour, land, capital) and new factors (i.e., data, technology, ecology), with a mutually reinforcing relationship between factor flow and urban-rural integration. Subsequently, the study dissects the practical impediments to factor flow in the project’s implementation: institutional barriers from fragmented policies and ambiguous property rights; market-level challenges including regional factor deficits and supply-demand mismatches; technological constraints arising from urban-rural digital infrastructure gaps and insufficient digital literacy; and governance shortcomings such as weak village collective capacity and inadequate risk prevention mechanisms. Finally, targeted innovative pathways are proposed to meet the project’s factor flow needs, encompassing institutional breakthroughs, market activation, technological empowerment, and governance coordination. This research provides practical insights for Guangdong to resolve urban-rural development imbalances and deepen the project’s implementation, while also offering Guangdong’s experience for promoting nationwide urban-rural integration.

ABSTRACT Fire accidents can cause severe damage to aircraft and jeopardize passenger safety. Current research on civil aviation safety generally focuses on guaranteeing continued operational safety and airworthiness, typically treating fire as a potential hazard or risk factor. In addition, fire prevention design in civil aviation is generally based on pessimistic assumptions that components have lost their intended functions in fire scenarios, leading to redundant or inadequate fire prevention design. Therefore, this paper proposes a probabilistic assessment methodology for structural failure severity of aero‐engine components in fire scenarios based on cumulative failure frequency (CFF). The proposed methodology first considers all possible combinations of fire scenarios that may occur in an aero‐engine by discretizing the probability distributions of the random variables associated with these scenarios. Subsequently, fire simulation using the fire dynamics simulator in conjunction with heat transfer analysis is carried out to determine the temperature distribution of structural elements. To enhance the computational efficiency of consequence analysis, a temperature approximation model based on the extreme learning machine is then introduced to reduce computational burden. Finally, structural failure severity is quantified by identifying the state of each structural element with the inclusion of the transition state and calculating the corresponding CFF. A case study is presented to demonstrate the applicability of the proposed methodology in identifying critical structural elements in fire scenarios, thereby validating its practicality and effectiveness.

Background: Rabies is a fatal but vaccine-preventable zoonotic disease that remains a major public health concern in developing countries. In Pakistan, thousands of deaths occur annually due to inadequate awareness, prevention, and control measures. Objectives: This study aimed to assess the perceptions of medical students about rabies in a medical college in Lahore, Pakistan. Method: A cross-sectional analytical study was conducted on 350 medical students through stratified random sampling. The study was conducted during November 2022 to July 2023. At University College of Medicine at University of Lahore, Pakistan. Data was described and analyzed using SPSS version 24. Ethical approval was obtained from institutional IRB. Results: Among 350 medical students (50% male, 50% female, mean age 21.63), 94% correctly identified rabies as a central nervous system disease, 87.7% recognized dogs as potential rabies carriers, but only 10.86% had awareness of other animals involved in transmission. Approximately 62.85% had knowledge of animal vaccination, while 5.71% were aware of sterilization of dogs as a measure to prevent rabies. Only 63.14% were informed of a rabies vaccine for humans. Knowledge of correct doses for pre-exposure prophylaxis (PrEP) was known to 8% and post-exposure prophylaxis (PEP) to 10%. Awareness of Rabies Control and Trap-Neuter-Vaccinate-Return (TNVR) programs was regrettably low (3.42% and 1.42% respectively). Responses pertaining to attitude were moderate, with 29.4% considering aggressive wound washing immediately after a stray dog bite. Furthermore, about 36.6% had attended a rabies awareness workshop but only 1.4% had seen a dog bite center in Lahore. Analysis of associations revealed that knowledge was significantly associated with gender (?²=6.84, p=0.009), class year (?²=10.21, p=0.037), and age (?²=8.15, p=0.017), with male, senior, and older students showing better knowledge. Similarly, practice was significantly associated with gender (?²=7.22, p=0.007), class year (?²=12.35, p=0.015), and age (?²=9.48, p=0.009), where male, senior, and older participants demonstrated better preventive practices. Conclusion: Significant gaps in medical students' perception about rabies exist. Improving education and awareness among future healthcare providers is crucial to effectively prevent and manage rabies in the community. Both knowledge and practice were found to be significantly associated with gender, class year, and age, with male, senior, and older students performing better.

Assessment of adherence to the neonatal resuscitation program using video recording: a prospective observational study