Author: watheq mohammed

ABSTRACT Background Pharmacist board certification through the Board of Pharmacy Specialties (BPS) is expanding in many developed countries; however, research on this topic in the Middle East remains limited. This study aimed to assess the perceptions, motivations, barriers, and factors associated with pharmacists pursuing BPS board certification in Middle Eastern countries. Methods A cross-sectional online questionnaire consisting of multiple sections assessing demographics, knowledge, attitudes, motivations, barriers, and job satisfaction was distributed to licensed pharmacists across Middle East countries between October 2024 and January 2025 via professional and social media platforms using a snowball sampling approach. Results A total of 1631 pharmacists participated in the study, of whom 512 (31.4%) were board certified. Board-certified pharmacists reported higher levels of pride and self-confidence related to their certification status (p < 0.001). Multivariable logistic regression showed that lower-income pharmacists were more likely to seek board certification (odds ratio [OR] = 2.2; 95% confidence interval [CI]: 1.4–3.4; p < 0.001). Conversely, lack of guidance regarding BPS certification (OR = 0.55; 95% CI: 0.40–0.76; p < 0.001) and insufficient financial support (OR = 0.59; 95% CI: 0.40–0.84; p = 0.003) were associated with lower odds of certification. Pharmacists who learned about certification through an instructor (OR = 1.9; 95% CI: 1.4–2.57; p < 0.001) or through journal articles (OR = 1.36; 95% CI: 1.01–1.8; p = 0.045) were more likely to pursue a certification. Conclusion This study identifies key regional barriers toward pursuing board certification particularly limited guidance and financial constraints which highlights the need for targeted strategies such as mentorship, employer support, and educational outreach to enhance certification uptake and strengthen the pharmacy workforce in the Middle East.

Abstract Background: In Iraq, oncology patients with bloodstream infections face escalating treatment challenges due to rising antimicrobial resistance in Escherichia coli, compounded by limited diagnostic capacity and restricted therapeutic options. However, data from oncology settings in Iraq are limited. This study aimed to characterize and compare the antimicrobial resistance gene profiles of multidrug-resistant and antibiotic-sensitive E. coli isolates from cancer patients, to inform infection control and stewardship strategies. Methods: A prospective, multicenter investigation was conducted in three oncology hospitals in Baghdad. Fifty-five Escherichia coli bloodstream isolates, 36 multidrug-resistant (MDR) (65.5%) and 19 antibiotic-sensitive (34.5%), underwent phenotypic susceptibility testing using VITEK® 2 and disk diffusion. Whole-genome sequencing (Illumina MiSeq) was performed, and antimicrobial resistance genes (ARGs) were identified using AMRFinderPlus and classified by functional category. Results: MDR isolates showed a broad resistome dominated by efflux systems. Across all isolates, a total of 36 unique antimicrobial resistance genes were identified, underscoring substantial resistome diversity., efflux pump genes were detected in 100%, β-lactamase genes in 88.9%, macrolide resistance genes in 66.7%, tetracycline resistance genes in 55.6%, and aminoglycoside resistance genes in 41.7%. Representative determinants included AcrAB-TolC/EmrAB-TolC/MdtABC-TolC (efflux) and BlaEC family/CMY-42/TEM types (β-lactams). Among sensitive isolates, only 11 antibiotic-associated genes, mainly efflux or regulators (e.g., acrF, emrD, emrR, emrY, tolC; regulators marR, evgA; target parC; others baeS, cpxA, cysB), overlapped with MDR, suggesting a shared core that is insufficient alone for phenotypic resistance without additional high-level mechanisms. Conclusions: Multidrug-resistant E. coli from oncology patients harbor dense, efflux-driven resistomes supplemented by diverse β-lactamases and other resistance determinants, while sensitive isolates retain a limited core set of genes. Genomic surveillance in cancer centers is critical for anticipating resistance emergence and informing targeted antimicrobial strategies. 10.31557/APJCP.2026.27.3.1037

ABSTRACT Background Antimicrobial resistance (AMR) is a major threat in oncology, where immunosuppression and repeated healthcare exposure increase susceptibility to severe infections. Multicenter data on antibiotic resistance patterns among cancer patients in Iraq remain limited. Research design and methods A multicenter observational study was conducted across three oncology centers in Iraq between January 2024 and March 2025. A total of 125 non-duplicate blood culture isolates from patients with hematological and solid malignancies were analyzed, including 100 resistant and 25 susceptible isolates. Antibiotic susceptibility testing followed Clinical and Laboratory Standards Institute criteria, and categorical variables were analyzed using chi-square tests. Results Multidrug-resistant and carbapenem-resistant phenotypes were frequent among Klebsiella pneumoniae (35/100, 35%), Escherichia coli (36/100, 36%), and Pseudomonas aeruginosa (29/100, 29%). P. aeruginosa showed the highest burden of advanced resistance phenotypes, including difficult-to-treat resistance. Resistant isolates were more common in patients with hematological malignancies (77/100, 77%) than in those with solid tumors (23/100, 23%). Resistance was prominent for third-generation cephalosporins, fluoroquinolones, and β-lactam/β-lactamase inhibitor combinations, whereas tigecycline and colistin retained greater activity against several resistant isolates. Conclusions This study identified substantial antibiotic resistance among bloodstream isolates from cancer patients in Iraq, supporting oncology-specific surveillance and antimicrobial stewardship. https://doi.org/10.1080/14787210.2026.2690000

Abstract 50% of cases of infertility are caused by male factor, which acquired or congenital problems may bring on. Male infertility can be caused by oligospermia and asthenozoospermia, which are common. Since the same mutations that cause azoospermia in some people also cause oligozoospermia in others, oligozoospermia may be thought of as a less severe form of azoospermia. Studies have demonstrated telomere length, catalase activity, super oxide dismutase (SOD), and DNA fragmentation can be influential factors for male infertility. The amount of apoptosis, oxidative stress factors, telomere length, and DNA fragmentation were some aspects of healthy sperm that we chose to look into in this study and compare to oligospermia individuals. Oligospermia patients (n = 24) and fertile men (n = 27) semen samples were collected, and the apoptosis rate of sperms in both groups was analyzed (Flow cytometry). Also, gene expression of apoptotic and antiapoptotic markers and telomere length were examined (real-time polymerase chain reaction). The sperm DNA fragmentation kit was used to determine DNA fragmentation and to evaluate catalase and SOD activity; the specific kits and methods were utilized. Higher expression levels of caspase3 (p = .0042), caspase8 (p = .0145), caspase9 (p = .0275), and BAX (p = .0202) mRNA were observed in patients who had oligospermia. In contrast, lower mRNA expression of BCL-2 (p = .0009) was detected in this group. In addition, telomere length was decreased in the oligospermia group (p < .0001) compared to the health group. Moreover, the frequency of apoptosis is induced in patients (p = .0026). The catalase activity is low (p = .0008), but the SOD activity is high (p = .0015) in the patient group. As a result of our findings, we may list the sperm cell apoptosis rate, telomere length, the degree of sperm DNA fragmentation, and lastly, the measurement of significant and efficient oxidative stress markers like SOD and catalase in semen plasma among the principal diagnostic characteristics for oligospermia. Future studies will be better able to treat oligospermia by showing whether these indicators are rising or falling. https://doi.org/10.1002/cbf.3935Digital Object Identifier (DOI)