Objective: The objective of this review is to analyze the hidden curriculum with respect to its potential as a curriculum promotor or inhibitor of medical curricula, and to review the strategies that can help make it one of the curriculum promotors. Data Sources: We searched PubMed, Cochrane Reviews, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) library, with Google Scholar for grey literature, using specified keywords with a time limit from January 2000 to December 2023. We included original articles, review articles and meta-analyses, book chapters, and books focusing on the hidden curriculum effects on curriculum. Data Extraction and Synthesis: Three different reviewers independently searched the relevant literature. The Best Evidence Medical Education (BEME) quality criteria were used to assess the quality, the Critical Appraisal Skills Program (CASP) checklists for risk of bias assessment, and the GRADE-CERQual framework for confidence of evidence in each article. Findings were synthesized by using thematic synthesis to identify promotive and inhibitory effects along with recommended strategies. Results: A total of 23 articles were selected for full review. These articles infer that the hidden curriculum can affect the medical curriculum in both negative and positive ways. A few of the curriculum-promoting effects of hidden curriculum are soft skills (interpersonal, communication, and professional behaviors often labelled as soft skills in the literature) and practical knowledge acquisition, cultural proficiency, moral growth, and professionalism. The negative or inhibitory effects include a detrimental learning environment, learning unprofessional and unethical practices, gender inequities, stress, and burnout. Strategies that should be adopted to overcome the inhibitory effects of the hidden curriculum include raising awareness among the stakeholders regarding the hidden curriculum, aligning the hidden curriculum with the intended curriculum, institutional and administrative policies, role modelling, and mentorship. Conclusion: Hidden Curriculum plays a very crucial role in medical education. By addressing its due importance, it can highly enhance the competence of future health professionals.

: Staphylococcus aureus causes a wide range of illnesses, from skin infections and persistent bone infections to life-threatening septicemia and endocarditis. Methicillin-resistant S. aureus (MRSA) is one of the most common bacteria that cause nosocomial and community-acquired infections. Clindamycin is one of the most effective treatments for several bacterial infections. Despite this, these infections may develop inducible clindamycin resistance during treatment, leading to treatment failure. This study determined the incidence of inducible clindamycin resistance among S. aureus clinical isolates. A total of 800 S. aureus strains were identified from clinical samples collected from several university hospitals in Egypt. All isolates were examined for the presence of MRSA using cefoxitin (30 μg) and the Kirby Bauer disk diffusion technique. The induction phenotypes of all 800 S. aureus strains were evaluated using the disk approximation test (D test), as recommended by the Clinical and Laboratory Standard Institute. Of the 800 strains of S. aureus, 540 (67.5%) were identified as MRSA and 260 (32.5%) were classified as methicillin-sensitive S. aureus (MSSA). In MRSA infections, clindamycin constitutive and inducible resistance was more frequent than in MSSA infections (27.8% versus 11.5% and 38.9% versus 15.4%, respectively). Clindamycin-sensitive strains were more prevalent in MSSA (53.8%) than in MRSA (20.4%) infections. In conclusion, the frequency of constitutive and inducible clindamycin resistance in MRSA isolates emphasizes the need to use the D test in routine antimicrobial susceptibility testing to evaluate clindamycin susceptibility, as the inducible resistance phenotype can inhibit the action of clindamycin and thus affect treatment efficacy.

Background: Continuous training of the faculties is important to both individual and organizational performance. Faculty development programs (FDPs) are applied to prepare highly skilled faculties. Positive transfer of training to the workplace is the main factor judging the effectiveness of the training. The aim was to evaluate transfer of training of the faculties of Tanta Faculty of Medicine after attending one of FDPs in competency-based medical education. Methods: This mixed quantitative and qualitative study was carried out at the Faculty of Medicine, Tanta University. Quantitative data were collected via responses to digital questionnaires with 5-point Likert Scale from 177 of the trained faculties during the period from 2017 to 2022. Qualitative data were gathered from eight focus group discussions with students and nine interviews with the courses’ coordinators. Transfer of training was evaluated according to Kirkpatrick’s Four Levels of Training Evaluation Model. Descriptive statistics and thematic analysis were used to analyze the collected data.Results: Out of 177 participants, 87% reported an increase in their self-confidence as medical teachers, 87% adopted new teaching methods and 88.4% new assessment methods. Students noted effective class management but a weak student-teacher bond, while coordinator interviews clarified that FDPs improved teaching quality.Conclusion:A positive transfer of training after these FDPs was obvious and a satisfactory impact on the performance of faculties as well as the overall performance of the faculty were detected. Continuing training of the faculties is recommended as an essential need to guarantee the fruitful learning environment

It is crucial to identify Enterobacterales that produce carbapenemase to treat and manage hospital infections. The suggested techniques for their identification need a lengthy wait, technical knowledge, and training. Lateral flow immunoassays (LFIAs) provide a solution to these requirements. Thus, this study compared LFIA with phenotypic and genotypic tests for carbapenemase-producing bacteria. Fifty clinical isolates of carbapenem-resistant superbugs were examined. KPC, VIM, NDM, IMP, and OXA-48-like enzymes were evaluated and compared with phenotypic tests and LFIA. Regarding the phenotypic characteristics, the mCIM was positive in 37/50 (74%), and the eCIM was positive in 21/50 (42%). Regarding using LFIA, 41 out of the total isolates (82%) gave a positive red line with one or more of the tested genes. The most frequently detected gene was bla_NDM (27/50 (54%)), and the least detected one was bla_IMP (14/50 (28%)), which was in accordance with the PCR results. While investigating the accuracy of LFIA vs. PCR, it was found that LFIA had 100% sensitivity in the detection of the bla_NDM and bla_OXA genes, with 85.2% and 91.4% specificity, respectively, while for the bla_IMP, bla_KPC, and bla_VIM genes, the values were 91.7% and 92.1%, 94.1% and 90.9%, and 95.5% and 89.3%, respectively. The overall accuracy of LFIA ranged from 92 to 94%. Our comparison with molecular assays revealed remarkable agreement, so we propose that this test might be utilized as a supplementary tool.

Chemotherapy remains foundational to oncology, yet treatment response, resistance, and gastrointestinal toxicity vary widely between patients in ways that tumor stage, molecular subtype, and host pharmacogenomics do not fully explain. The gut microbiome contributes to this variability through two primary mechanisms: direct biotransformation and bioaccumulation of cytotoxic agents by microbial enzymes, and indirect modification of epithelial barrier integrity, inflammatory tone, and ecological resilience after cytotoxic injury. We propose precision pharmacomicrobiomic conditioning: the drug-specific, timing-anchored preservation or reshaping of microbial function before and during chemotherapy, which is distinguished from generic microbiome modulation by its linkage to a defined pharmacologic and toxicity profile. We operationalize this concept through two original constructs: five-archetype baseline risk classification stratifying patients by microbial enzymatic, inflammatory, ecological, and recovery phenotypes; and a three-phase clinical workflow specifying the assay, time point, and decision rule from pre-treatment stratification through adaptive longitudinal monitoring. These constructs are proposed strictly for prospective validation and are not presented as clinically validated decision tools. Furthermore, while dynamic functional and metabolic biomarkers may have higher predictive value than static, single bacterial taxa, this hypothesis requires rigorous confirmation in sufficiently powered, externally validated clinical cohorts. We conclude with the minimum reporting standards required to test these constructs: chemotherapy exposure metrics, toxicity grading versions, functional and strain-level profiling, and engraftment endpoints, and position microbiome profiling as an additional stratification layer integrated with pharmacogenomics and conventional clinical predictors, not as independent grounds for dose modification. Currently, no microbiome-derived biomarker has undergone prospective validation or received regulatory approval for standard chemotherapy stratification.

To improve clinical decision-making about Carbapenem-resistant Gram-negative bacteria (CR-GNB) infections and halt the spread of resistant microbes, quicker and less expensive diagnostic techniques are required. Thus, the purpose of this study was to thoroughly evaluate the diagnostic efficiency (sensitivity, specificity, and concordance) of direct-from-specimen multiplex lateral flow immunoassay (LFIA) across diverse raw clinical specimens and pathogen types from critically sick patients. A total of 300 non-duplicate samples were tested to detect CR-GNB. Five major Carbapenemase genes were detected directly from the specimen using carbapenem-resistant K.N.I.V.O. detection K-Set and from culture using culture-enhanced multiplex PCR. Turnaround time (TAT) of each method was calculated. The direct LFIA revealed 100% specificity for NDM, KPC, and IMP enzymes in all tested clinical matrices (blood, urine, and respiratory samples). The study demonstrated 100% sensitivity and specificity with perfect categorical agreement (κ = 1.000) for the blaKPC in the Klebsiella pneumoniae and for blaOXA-48 and blaIMP in the Acinetobacter baumannii; however, sensitivity of blaVIM was significantly diminished across all isolates and samples. TAT decreased significantly (p < 0.001) from 30 to 70 h to about 50 min. The tested direct LFIA facilitates the prompt enhancement of lifesaving tailored antibiotic treatment for severe illnesses.