ABSTRACT
Retail medicine outlets serve as the first point of contact for most Ghanaians seeking treatment for common ailments. However, weak regulation has led to the widespread dispensing of antimicrobials without a prescription in community pharmacies and over-the-counter medicine shops (OTCMS), fueling antimicrobial resistance (AMR). This cross-sectional study assessed the sale of prescription-only antimicrobials for common self-limiting conditions that do not require antimicrobial therapy in Tamale, northern Ghana. Using the simulated patient (SP) method, adult male actors presented with symptoms of urinary tract infection, upper respiratory tract infection, and acute diarrhoea. Three escalating levels of demand were employed to evaluate dispensing practices without a prescription. A total of 35 community pharmacies and 25 OTCMS were visited three times each, resulting in 180 SP visits. In community pharmacies, pharmacists were the most frequently encountered staff (34.3%), while medicine counter assistants predominated in OTCMS (44.0%). The overall prevalence of dispensing antimicrobials without a prescription was alarmingly high at 91.7% (165/180). Antimicrobials were commonly sold at the first level of demand, 64.8% in community pharmacies and 86.7% in OTCMS. Watch group antibiotics were more frequently dispensed in pharmacies (45.8%), whereas Access antibiotics dominated in OTCMS (47.3%). The most dispensed agents were ciprofloxacin (19.6%), amoxicillin-clavulanic acid (14.4%), and doxycycline (11.0%). This study reveals widespread violations of national regulations governing antimicrobial sales, particularly in OTCMS where such sales are illegal. Urgent implementation of antimicrobial stewardship programmes, stricter enforcement of regulations, and targeted staff training are recommended to curb irrational antimicrobial use and combat AMR in Ghana.

ABSTRACT
Background: Infectious diarrhea remains a significant global health concern, especially in less developed regions. The disease's impact on children under five years old is particularly severe, causing a high mortality rates in Low- and Middle-income Countries (LMICs). Objectives: The study aimed to investigate to characterize bacterial causative agents of diarrhea among children below 5 years attending Kiandutu Health care center in Thika, Kiambu County. It also sought to determine the antibiotic susceptibility testing of the isolated bacteria among children below 5 years attending Kiandutu Health care center in Thika, Kiambu County. Materials and Methods: The study utilized an exploratory descriptive approach because it will look at the many aspects of the disease incidence, including the onset of disease and treatment for the children attending Kiandutu Health Centre. Results: In characterizing the bacterial causative agents of diarrhea, Escherichia coli was isolated in 45.1%. In the remaining cases, in 54.9%, there was no growth or no pathogen isolated. In addition, MDR, which was defined as resistance to at least one agent in three different antimicrobial categories, was highly prevalent; it was identified in 78.3% (36/46) of the isolates. By stratification according to their ESBL status, all the ESBL-positive isolates showed MDR at 100% (23/23), compared to 56.5% (13/23) among the ESBL-negative isolates. The most sensitive antibiotic was chloramphenicol: 40 isolates were found to be sensitive and 6 resistants, giving a 13% resistance rate. Second to this was Amoxyclav, with 37 sensitive and 8 resistant. moderately effective antibiotic was ciprofloxacin, with 28 sensitive, 13 resistant, and 5 intermediates, yielding a 28.3% resistance rate. Conclusions and Recommendations: Resistance is ubiquitous, even among infections acquired within communities. Empiric antibiotic treatment is increasingly ineffective, with most first-line drugs failing against common pathoge

ABSTRACT
Carbapenem-resistant Enterobacterales (CRE) infections, which are associated with high morbidity and mortality, are increasingly reported worldwide, particularly in healthcare settings. This observational study investigated patients with CRE infections at an Indian tertiary care hospital. The infections predominantly affected elderly individuals: the 61–80 age group accounted for 59.4% of cases, while the 71–80 subgroup alone comprised 38.6% of patients. Regarding hospital stay duration, nearly half of the patients (48.3%) were hospitalized for 0–10 days, whereas 31.0% remained hospitalized for 31 days or more. The most frequently utilized indwelling devices were Foley catheters, followed by nebulizers, nasogastric (NG) tubes, and ventilators. Microbiologically, Klebsiella pneumoniae was the primary isolate (58.6%), followed by Escherichia coli (27.3%), Pseudomonas aeruginosa (6.1%), Acinetobacter baumannii (2.0%), non-lactose fermenters (2.0%), and Providencia rettgeri, Enterobacter cloacae, and Aspergillus spp. (2.0% each). This study highlights the clinical and microbiological characteristics of CRE isolated from hospitalized patients. Genetic analysis revealed that blaNDM and blaOXA-48 were the most prevalent carbapenemase genes, while blaKPC and blaIMP occurred less frequently. Notably, several isolates co-harbored multiple resistance genes (such as blaNDM and blaOXA-48, suggesting the emergence of multidrug-resistant variants with complex resistance determinants.

ABSTRACT
Lower gastrointestinal bleeding and rectal prolapse in children have a broad differential diagnosis influenced by age, nutritional status, comorbidities, and geographical exposure. In endemic regions, intestinal schistosomiasis should be considered among infectious causes of chronic gastrointestinal blood loss and inflammatory colorectal disease. Rectal prolapse secondary to schistosomiasis is rare, and operative intervention is infrequently required. A 5-year-old girl presented with a six-month history of intermittent rectal bleeding and full-thickness rectal prolapse, accompanied by progressive weakness and abdominal distension. Severe microcytic hypochromic anaemia was identified, with a haemoglobin level of 2.7 g/dL. After blood transfusion and clinical stabilisation, open abdominal sacral rectopexy was performed because of persistent, ulcerated prolapse with ongoing bleeding and failure of conservative management. Intraoperative findings included thickening of the sigmoid colon, whitish serosal patches, enlarged mesenteric lymph nodes, and hepatomegaly. Stool ova testing was requested but unavailable. Histopathological examination of biopsied tissue revealed active Schistosoma eggs within granulomas, confirming the diagnosis. This case illustrates an advanced presentation of intestinal schistosomiasis in a young child, complicated by life-threatening anaemia and full-thickness rectal prolapse requiring surgical correction. In endemic settings, children with chronic rectal bleeding, anaemia, abdominal symptoms, or prolapse should undergo targeted evaluation for schistosomiasis. When stool microscopy is unavailable or inconclusive, histopathology can provide definitive confirmation. Earlier recognition, guided by exposure history, appropriate ova testing, and haemoglobin assessment, may reduce the risk of progression to severe complications.

ABSTRACT
Haemonchis is a major health and welfare problem for small ruminants responsible for economic losses through reduced productivity and increased mortality. The in vitro efficacy of Callistemon rigidus was determined against Haemonchus contortus the most important parasite involved in this animal disease. Fresh eggs, infectives larvae (L3) and female’s adult were incubated at room temperature in aqueous and ethanolic extracts of C. rigidus for 24 h; 24 and 48h for effectivity assessment. The PBS used as negative control did not affect the involved developmental stages. Aqueous and ethanolic extracts induced 100 % mortality of female’s adults at 1 mg/mL with LC50 values of 0.067 ± 0.01 mg/mL and 0.067 ± 0.011 mg/mL respectively. The inhibition of eggs hatching rate varied from 12.33±2.08 % to 83.67±2.21 % with LC50 value of 0.351 ± 0.023 mg/mL. While the ethanolic extract inhibited 15.33±1.53% to 100±00% with LC50 value of 0.269 ± 0.005 mg/mL eggs hatching. The larval mortality rates increased from 62.5±9.57 % to 91.66±9.62% for aqueous extract with LC50 value 0.2±0.02 mg/mL and from 78.93±6.53% to 100±00% for ethanolic extract with a corresponding LC 50 value of 0.12±0.01mg/mL. Finaly, this study indicated that C. rigidus possess potential anthelmintic effect and further in vivo study is indispensable to validate its use as alternative anthelmintic against that GIN.

ABSTRACT
Poor menstrual hygiene is a significant public health issue, especially among female students in tertiary institutions where academic pressure, limited facilities, and social stigma can worsen hygiene practices. Its impact on reproductive health is both immediate and long-term. Poor hygiene practices (such as prolonged use of one pad or improper cleaning) may alter the natural vaginal pH and encourage growth of harmful bacteria and fungi. This imbalance can lead to conditions like bacterial vaginosis and yeast infections, which affect reproductive health and comfort. This study aimed to Assess Impact of Poor Menstrual Hygiene on Reproductive Health among Female Students in Tertiary Institutions in South-South, Nigeria. This was a cross-sectional study involving 250 women. Participants’ age is between 18 to 47 years. A well-structured questionnaire was administered to participants. The study lasted for a period of 3 months. Statistical analysis was done using SPSS version 25.0 and p < 0.05 was significant. The results revealed that 60% of the participants were university students, 76% have no knowledge about menstrual hygiene, 60% changed change sanitary pad when it is completely soaked, 60% never washed before and after changing menstrual pad, 60% uses tissue materials as pad, 60% do not have access to clean water and toilet facilities during menstruation, 40% disposed used pads in open dumping, 60% are not comfortable during menstruation within school environment. The participants also experienced the following after poor menstrual hygiene including vaginal discharge, bacterial infection, PID, UTI, vaginitis and others, 76% have missed classes due to menstrual discomfort or hygiene challenges.

ABSTRACT
India carries one of the heaviest vector-borne disease burdens in the world. Dengue, malaria, chikungunya, japanese encephalitis, and kala-azar together kill thousands of Indians every year and push millions more into catastrophic health expenditure. The country's surveillance infrastructure, while improving steadily, still relies on passive case detection, delayed reporting, and manually aggregated data that reaches decision-makers too late to prevent outbreaks from spreading. Over the past decade, artificial intelligence has begun entering this space through disease forecasting models, satellite-driven risk mapping, social media-based early warning tools, and AI-assisted diagnostics. This paper examines these developments specifically in the Indian context. It surveys the technical tools being deployed, their performance as reported in Indian studies, the regulatory and ethical questions they raise under Indian law, and the institutional obstacles that explain why AI in Indian public health has so far produced more pilot projects than operational systems. The argument advanced here is that AI can genuinely improve India's vector-borne disease response, but only if it is built on better data infrastructure, governed under a coherent regulatory framework, and deployed with the realities of India's district health system in mind rather than the requirements of a research paper.