Objectives: Intrinsic capacity (IC) is the composite of physical and mental capacities, reflecting the overall functional ability in older adults. Evidence on IC decline in Malaysia remains limited; therefore, this study examined the prevalence of decline across six IC domains and identified key sociodemographic and clinical associations. Methods: This cross-sectional study recruited 329 older adults from three Pusat Aktiviti Warga Emas centers in Kedah, Malaysia. Their IC was assessed using the World Health Organization-Integrated Care for Older People Step 1 screening tool across six domains (Mini-Mental State Examination, Short Physical Performance Battery, Mini Nutritional Assessment–Short Form, Geriatric Depression Scale–15, visual acuity self-report, and whisper test self-report). Data were analyzed using multivariable logistic regression adjusted for weight, body mass index, and gender, and expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: IC decline was most common in vision (69.6%) and cognition (52.6%), followed by locomotion (40.1%), vitality (30.4%), hearing (23.1%), and psychological function (17.9%). Overall, 77.2% had impairment in at least one domain. Significant associations were observed between walking-aid use and decline in locomotion (aOR = 7.75), vitality (aOR = 1.99), and hearing (aOR = 3.55). Non-Malay ethnicity was associated with higher odds of psychological decline (aOR = 4.09) but lower odds of vitality decline (aOR = 0.28). Multimorbidity was associated with increased odds of vitality and psychological decline, while higher education was associated with lower odds of cognitive impairment (aOR = 0.35). Conclusion: IC decline was highly prevalent, particularly in vision and cognition. These findings suggest the need for early, community-based, multidisciplinary strategies to preserve function and promote healthy aging.

Background: Botulinum toxin injections are widely used in the orofacial region for cosmetic and therapeutic purposes. Recently, interest has grown in combining Botulinum toxin A injection with facial exercises to enhance or sustain aesthetic and functional outcomes. Objective: To examine the efficacy of Botulinum toxin injections with facial exercise on orofacial disorders. Methods: A comprehensive electronic literature search was conducted across databases. Studies were screened for eligibility, and reviewers independently assessed quality and bias. Results: An electronic search of databases up until Feb 2026 revealed 164,916 Articles. Seven studies met the inclusion criteria, including four RCTs and three prospective clinical studies conducted in a hospital-based setting. Different Botulinum toxins have been used in these studies. Two studies used Onabotulinumtoxin A, two used botulinum toxin (Dysport), and two RCTs used botulinum A toxin (Botox). Additionally, the presented studies performed various myofunctional therapy. Conclusion: The current evidence suggests that facial exercise following Botulinum toxin A injections may enhance treatment outcomes in the orofacial area by sustaining muscle tone and prolonging aesthetic benefits. Further research with larger sample sizes and standardized protocols must establish the effectiveness and best practices of this combined approach.

Background: Adherence to Tuberculosis (TB) therapy is critical to achieving a cure. Effective patient education could influence treatment-related attitudes and behaviors, thereby enhancing therapeutic compliance and optimal health outcomes. Aim: To assess the effect of health education on treatment adherence among drug-sensitive pulmonary TB patients in ten DOTS facilities in Ebonyi State. Method: A quasi-experimental design was employed to recruit 248 respondents drawn from a population of 487 patients using a multi-stage sampling approach. The intervention and control groups consisted of 129 and 119 respondents, respectively, with the intervention group receiving a two-month health education package and the WHO standard routine care, while the control group received only the WHO standard routine care. A validated questionnaire was administered to the respondents before and after the intervention. Result: The intervention group achieved 99.2% TB knowledge, 97.7% attitude, and 88.3% treatment adherence after the intervention. However, the control group showed 83.2%, 73.9%, and 68.1% for knowledge, attitude, and treatment adherence, respectively. There was a statistically significant difference between sex and level of treatment adherence in the intervention group, with females showing higher adherence (p<0.049). Conclusion: The study showed that regular health education improves patients’ knowledge, attitude, and adherence to TB treatment.

Purpose: The purpose of this article was to analyze the relationship between nurses' digital health literacy and emotional exhaustion in tertiary care hospitals. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Based on current research, a significant inverse relationship exists between nurses' digital health literacy and emotional exhaustion in tertiary care hospitals. Higher proficiency in using digital health tools and navigating electronic health information is consistently associated with lower levels of emotional exhaustion, a core dimension of burnout. This suggests that improving digital health literacy may serve as a protective factor, enhancing work efficiency and reducing the technological stress that contributes to burnout among nurses in high-complexity care settings. Unique Contribution to Theory, Practice and Policy: Job demands-resources (JD-R) theory, transactional model of stress and coping conservation of resources (COR) theory may be used to anchor future studies on the relationship between nurses' digital health literacy and emotional exhaustion in tertiary care hospitals. For hospital administrators and nurse leaders, this study provides actionable, evidence-based strategies to mitigate burnout by targeting a modifiable skill set. At the policy level, this research provides a compelling evidence base to advocate for systemic changes that protect the nursing workforce in an increasingly digital healthcare ecosystem.

Purpose: This study aimed to analyze the potential of decentralized health service delivery in addressing the performance of healthcare workers in Uganda. Methodology: We adopted desk research in which relevant secondary literature was reviewed throughout to identify the link and gaps existing therein. This is a qualitative research method adopted with a view of understanding the complexities of decentralized healthcare service delivery and its impact on Primary Health Care worker performance. Four research questions are asked and answered in line with resource allocation, training, recruitment, and supervision. Findings: The outcomes reveal that decentralized practices may influence healthcare worker performance. We argue that decentralization fosters improved healthcare delivery and worker effectiveness thus highlighting decentralization as a critical strategy for strengthening primary healthcare systems and addressing community-specific health needs in Uganda. Unique Contribution to Theory, Policy and Practice: This study contributes to the strategic shift towards decentralized service delivery, particularly in healthcare, as an empowering tool to local governments and communities, by transferring authority from central administrations as a modus operandi to improved service delivery. It is encouraged that policy makers strengthen strategies that promote decentralization in health service delivery.

Objectives: Breast cancer (BC) is the most common cancer in women worldwide and has poor survival outcomes. The human epidermal growth factor receptor 2 (HER2), a key promoter of tumor progression and metastasis, is overexpressed or amplified in 15–20% of BC cases, leading to worse prognosis. The introduction of anti-HER2 monoclonal antibodies has significantly improved survival in advanced HER2-positive BC. Current HER2 testing in routine diagnostic practice relies on immunohistochemistry (IHC) and in situ hybridizations (ISH) techniques as US Food and Drug Administration-approved methods. However, these standard methods still have some limitations related to subjectivity, reproducibility, accuracy, and cost. To overcome these challenges, this study investigated droplet-based digital polymerase chain reaction (ddPCR) as a breakthrough technology for absolute DNA quantification. Methods: The ddPCR is a reliable third-generation PCR-based technology that has higher sensitivity, accuracy, and reproducibility. The HER2 gene status testing was assessed using ddPCR in a retrospective cohort of 36 formalin-fixed and paraffin-embedded tissues from BC patients with invasive ductal carcinoma. Results: Our results showed that ddPCR has very high concordance rates of 81% and 83% with IHC and brightfield double ISH (BDISH), respectively. Conclusion: These findings highlight the high accuracy and concordance of ddPCR with both BDISH and IHC, emphasizing its potential usefulness for HER2 testing in BC. After further optimization and standardization in larger cohorts, ddPCR hold the promise to become a rapid, reliable, and cost-effective alternative method suitable for the accurate assessment of HER2 gene status and other amplification-based genes for oncotherapies.

Objectives: Mutations in mitochondrial deoxyribonucleic acid (mtDNA) are a known cause of maternally inherited deafness and other mitochondrial disorders. These mutations often disrupt mitochondrial translation and oxidative phosphorylation, particularly affecting high-energy tissues such as the auditory system. This study aimed to identify mtDNA mutations in the 12S ribosomal RNA (rRNA), 16S rRNA, and mitochondrial transfer RNA for valine gene ( MT-TV ) loci and assess their pathogenicity using updated bioinformatic tools. Methods: A cross-sectional genetic study was performed from 2015 to 2016 involving 71 students (31 females and 40 males) aged 12–16 years, all exhibiting bilateral sensorineural hearing loss with maternal inheritance. DNA was isolated from saliva samples utilizing the phenol–chloroform technique. A 795 base pair fragment encompassing the 3’ terminus of 12S rRNA, the entire MT-TV, and the 5’ terminus of 16S rRNA was amplified and sequenced. Variants were aligned with the revised Cambridge reference sequence and evaluated utilizing the Mitochondrial transfer RNA informatics predictor (MitoTIP) pathogenicity scoring system. Results: Fifty samples produced high-quality sequences, uncovering 78 mtDNA variants. Significant mutations comprised m.1438A>G and m.1544A>T in 12S rRNA, along with m.1603A>C, m.1607T>G, and m.1623G>C in MT-TV , many of which exhibited MitoTIP scores surpassing 60%. Conclusion: Recurrent variants found in rRNA and transfer RNA loci may signify mutational hotspots responsible for maternally inherited deafness. These findings advocate for regional mtDNA screening and functional validation to enhance the diagnosis and management of mitochondrial hearing loss.

Objectives: Despite the large number of published studies and guidelines for determining antiphospholipid antibodies (aPLs), laboratory results can be contradictory, depending on the test used and the clinical data. This study aimed to investigate the agreement of antibody positivity between the commercial enzyme-linked immunosorbent assay (ELISA) kits from Quanta Lite and Euroimmun, to evaluate the analytical and clinical performance of the aPLs, and to compare the cutoff calculated by the laboratory with the manufacturer’s cutoff values. Methods: This study included 79 patients with primary antiphospholipid syndrome (APS), 47 patients with APS associated with systemic lupus erythematosus, and 56 healthy individuals. The immunoglobulin (Ig) G/IgM isotypes of anti-cardiolipin (aCL) and anti-β2-glycoprotein I (aβ2GPI) were determined in all serum samples. Results: We found that there was a significant difference between the manufacturer’s and calculated cutoff values for aβ2GPI IgG and IgM in terms of the number of patients identified as positive ( P < 0.001), but that there was no difference between the manufacturer’s and calculated cutoff values for aCL IgG and IgM. Using the manufacturer’s cutoff values, we found substantial agreement for aCL IgG (Kappa = 0.712) and aβ2GPI IgG (Kappa = 0.761), moderate agreement for aCL IgM (Kappa = 0.474), while fair agreement was found for aβ2GPI IgM (Kappa = 0.329), comparing the ELISA kits analysed. Using the calculated cutoff, we found substantial agreement for aCL IgG (Kappa = 0.712) and moderate agreement for aβ2GPI IgG (Kappa = 0.533) and aβ2GPI IgM (Kappa = 0.424), while fair agreement was found for aCL IgM (Kappa = 0.339). Conclusion: Our results indicate the need for further standardization of ELISA tests for the determination of aPLs, particularly in terms of selecting appropriate cutoff values.

Objectives: Human papillomavirus (HPV) is an infectious disease transmitted sexually. It is the direct cause of cervical cancer, and it incriminates in oropharyngeal, anal, and genital cancers. Vaccination is the main control measure to exclude infection. Awareness and knowledge regarding HPV in Saudi Arabia still need improvement. Vaccination acceptance suffers from some hesitancy. This systematic review aimed to assess awareness and knowledge of HPV and HPV vaccine among young adults (18–30 years) and evaluate obstacles that prevent vaccination. Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses principles, a systematic search strategy was constructed through PubMed, Science Direct, Google Scholar, Scopus, and Web of Science. The search involved studies published between January 2020 and June 2025. Cross-sectional and quantitative studies that evaluate HPV and HPV vaccine among young adults (18–30) in Saudi Arabia were included. After completion of data extraction, selected studies were qualified to determine the level of bias. Results: Ten studies achieved the eligibility criteria; they showed a variable degree of awareness (43–59.6%) with sample sizes ranging from 114–580 respondents. A knowledge shortage regarding high-risk genotypes of HPV, modes of transmission, and vaccination was observed among medical students and the public. Barriers toward vaccination varied between lack of awareness, ignorance about the eligibility of the age of vaccination, and issues related to culture, with a noticeably higher degree of awareness among females than among males. Conclusion: Enhancement of education programs is needed; future investigations should be directed to improve the educational campaigns to promote public awareness of HPV. The development of the medical curriculum is a necessity.

Objectives: Nephrotic range proteinuria (NRP) and nephrotic syndrome (NS) are common manifestations of glomerular diseases across age groups. Kidney biopsy remains the gold standard for diagnosis. However, in resource-limited settings, the availability of electron microscopy (EM) is restricted, necessitating evaluation of its diagnostic utility. This study aims to assess the histopathological spectrum of glomerular diseases in pediatric and adult patients presenting with NS and NRP, and to evaluate the diagnostic utility of EM. Methods: A total of 180 consecutive renal biopsies were analyzed according to the 2016 Renal Pathology Society Consensus guidelines. Results: Of the 180 patients, 36 (20%) were pediatric and 144 (80%) were adult. NS was more common in children (72.2%), while nephrotic-range proteinuria (NRP) without full-blown NS predominated among adults (52.8%). In pediatric patients with NS, the most frequent diagnosis was minimal change nephropathy (MCN) (38.5%), followed by focal segmental glomerulosclerosis (FSGS) (19.2%). Among pediatric NRP cases, MCN remained the most common (27.7%), with lupus nephritis (22.3%) and FSGS (16.6%) also notable. In adults with NRP, the leading diagnosis was FSGS (27.1%), followed by IgA nephropathy, membranous nephropathy (MN), and amyloidosis, each accounting for 11.8% of this subgroup. Among adults with NS, FSGS remained predominant (26.5%), followed by amyloidosis (17.6%) and MN (14.7%). EM contributed to diagnosis in 29.4% of all cases ( n = 53), being essential for diagnosis in 12.2% and supportive in 17.2%. EM was particularly crucial in identifying lupus podocytopathy, dense deposit disease, Alport syndrome, and early-stage MN, which may not be definitively diagnosed by light or immunofluorescence microscopy alone. Conclusion: FSGS and MCN are the most common causes of NS across age groups. The findings highlight a shifting spectrum of glomerular diseases, consistent with national and global trends. Although not routinely feasible, EM provides significant diagnostic value in selected cases. Preserving tissue for potential EM evaluation is strongly recommended, especially in ambiguous or complex presentations.