Background: Worldwide, an estimated 33 million children under the age of five years are projected to be infected with the respiratory syncytial virus (RSV), with 10% of those cases necessitating hospital admission and up to 199,000 deaths from the illness. Patients and Method: We tested 100 suspected patients for RSV infection, with the help of pediatrician . The study was conducted at the Ramadi Teaching Hospital for Maternity and Children /Al-Anbar. The period of study was from 1 December 2023 to 15 March 2024. Result: In this study, we examined 100 cases of respiratory infection, 58 cases were positive for RSV. Out of 58 cases with positive RSV, 32 were positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antigen, and from cases positive for SARS-CoV-2 antigen, 18 were confirmed positive for SARS-CoV-2 by polymerase chain reaction (PCR). The age of patients ranged from 1 month to under 5 years and 57% were males while 43% were females. Statistical analysis was performed on data from RSV-infected patients as well as age subgroup populations. Patients were classified into the following age groups:1 to 6 months N=36(36%), 6 to 12 months N=24(24%), 12 to 18months N=9 (9%), 18 to 24 months N=17(17%), and more than24 months N=14(14%). The serotype of RSV were N=15(25.8%) of serotype A and were N=43 (74.1%) of serotype B. Conclusion: RSV is the leading cause of sickness and death in newborns globally, especially in low- and middle-income nations. Palivizumab is crucial for preventing severe RSV LRTIs in high-risk newborns, but the excessively high cost prevents widespread use. During the Pandemic, primary preventative measures, such as hand hygiene and face masks, were more cost-effective in reducing RSV burden. In addition to the vaccination, non-pharmaceutical preventive hygiene measures should be implemented to reduce RSV spread globally, even after the coronavirus disease-19 (COVID-19) pandemic.

BackgroundLeprosy poses a significant challenge in low- and middle-income nations, particularly in certain geographies. While the MDT-MBR regimen has proven beneficial, treatment non-responsiveness remains a key obstacle to eradicating leprosy. Considering bedaquiline's promising outcomes in MDR-TB and pre-clinical leprosy investigations, this proof of concept study aims to ascertain bedaquiline's efficacy and pharmacokinetics-pharmacodynamics in patients with non-responsive multibacillary leprosy.MethodsThe study has two components- preclinical and clinical. Leprosy mouse footpad model was developed by inoculating M.leprae ( in BALB/C mouse footpad. Groups of animals using different dosing schedules and regimens for bedaquiline are compared against WHO-MDT regimen. Additionally, drug interaction study for evaluating interaction with concomitantly administered drugs was carried out in Swiss albino mice. For clinical study, a prospective, randomized, blinded end point assessment trial comparing bedaquiline based regimen with that of extended WHO-MDT regimen is being undertaken in treatment non responsive patients of leprosy (CTRI Registration No: CTRI/2022/09/045483). Primary and secondary outcomes include key clinical and microbiological criteria.ResultsThe preliminary findings of the study are found to be promising. After ensuring M.leprae growth in mouse footpad model in mouse after 8 months, it has been found that there is approximately one log decrease in the grown in BALB/C mice after 4 months of treatment with bedaquiline 25 mg/kg once a month. There was no change found in pharmacokinetic profile of bedaquiline, clofazimine and rifampicin when administered altogether as revealed by drug interaction studies. Ten patients have been randomized to each of the treatment arms and are on follow up for observation of outcomes.ConclusionIn conclusion, the initial findings support the potential of the bedaquiline-based regimen in addressing non-responsive multibacillary leprosy cases with minimal evidence of significant pharmacokinetic drug interaction. The findings warrant further exploration.DisclosuresAll Authors: No reported disclosures

Unfavorable perinatal complications, such as low-birth-weight infant, premature infant, and small for gestational age (SGA), continue to be significant community health emergencies in low- and middle-income nations. These results are mainly influenced by insufficient maternal diet quality and social inequality, and income disparity. Though several studies have researched these relations, there is a limited synthesis of their joint effect on prenatal results, underlining the essential of inclusive assessment. This scoping review is designed to map and make accessible statistics on maternal diet quality and social and economic factors in relation to intimidating delivery consequences among expectant mothers in developing countries. Re-examine the PRISMA-ScR guidelines. An exhaustive examination was performed in PubMed, Science Direct, MEDLINE, EMBASE, Cochrane Library, Web of Science, PsycINFO, CINAHL, Scopus, Google Scholar, and MedRxiv for investigations published between January 2000 and December 2024. Revision quality was assessed by the Newcastle-Ottawa Scale to ensure methodological consistency and rigor. Eighty-two studies met the inclusion criteria. Suboptimal dietary variety (≤ 5 food classifications per day) was importantly connected with underweight and premature at birth (AOR: 2.45; 95% CI: 1.55-3.87). Skipping meals was expected premature delivery (AOR: 2.62; 95% CI: 1.41-4.89), whereas food insufficiencies amplified the threat of intrauterine growth restriction (IUGR) (AOR: 2.18; 95% CI: 1.02-4.63). Narcotics misuse, uneducated, low income, being a country dweller, and reduced judgment self-sufficiency were reliably associated with associated effect. Nutrition during pregnancy and social exclusion, and poverty-stricken conjointly impact pregnancy outcomes in low- and middle-income countries. Integrated policies combining nutrition-specific interventions with socioeconomic empowerment are critical to improving maternal and neonatal health.

Extracorporeal membrane oxygenation (ECMO) for infectious causes of refractory cardiopulmonary failure is established as appropriate therapy in high-income countries. Its use in low- and middle-income nations for tropical infections is not well-studied, however, perhaps because most of these countries have not been historically able to offer ECMO support. Tropical infections remain an important cause of global morbidity and mortality, but the role of ECMO is poorly described. We identified a list of viral, bacterial, fungal, and parasitic infections that qualified as tropical infectious diseases. These included infections that were either a World Health Organization (WHO) designated Neglected Tropical Disease (NTD) or an infectious disease with a higher prevalence in the Tropics than elsewhere. We conducted a comprehensive review of existing literature regarding ECMO use to support these infections. Multiple viral, bacterial, fungal, and parasitic tropical infections have been supported by ECMO with varying success. leptospirosis, melioidosis, and tuberculosis are conditions suitable for venovenous ECMO support with frequent use in the literature and reported survival as high as 84% in Leptospirosis. Venoarterial ECMO has been successfully used in American trypanosomiasis-related cardiogenic shock as a bridge to transplant, with one center reporting a 71% survival rate. Dengue and malaria have been successfully supported with both venovenous and venoarterial ECMO. Mortality is relatively high (> 65%) in patients who receive ECMO for Middle Eastern Respiratory Syndrome. ECMO has also supported Echinococcal infections perioperatively. There are multiple tropical infections where ECMO use has not been published. As the use of ECMO expands globally, more patients with tropical infections may require ECMO in both endemic and non-endemic settings. We present a scoping review on the evidence base of ECMO use to support tropical infectious diseases, with data regarding feasibility in specific disease processes as well as clinical considerations for tropical diseases on the ECMO circuit.

Cervical cancer is one of the most serious health problems affecting women across the world, particularly in developing and middle-income nations. It develops mainly due to a persistent infection with high-risk types of the Human Papillomavirus (HPV), especially HPV16 and HPV 18, which are transmitted through sexual contact. This study is designed to evaluate the effectiveness of an awareness programme on knowledge regarding cervical cancer among women. The research design selected was a pre-experimental, one-group pre-test and post-test design, which helps in evaluating the difference in participants’ knowledge levels before and after the intervention. The study was conducted in the Chilkur, Moinabad Rural Community area of Hyderabad, Telangana. The target population for this study comprised women aged between 25 and 69 years residing in the selected community. A total of 100 participants was selected using a non-probability purposive sampling technique, based on their availability and willingness to participate in the study. A structured Interview Questionnaire administered to the samples followed with Awareness session on Cervical cancer and post test was conducted after the 7 days of intervention. The findings revealed that most participants were aged 30–39 years (31%), illiterate (33%), housewives (36%), and married (51%). The majority (42%) had irregular menstrual cycles, and 21% reported a family history of cancer.The mean pre-test score (9.25) increased to 14.76 in the post-test, indicating a notable improvement in knowledge following the awareness program. The obtained t-value (18.07) at df 99 and p = 0.001 confirms that the intervention was statistically significant in enhancing knowledge about cervical cancer. Therefore, the hypothesis H₁ is accepted, signifying a significant difference between pre- and post-test knowledge levels. The study concluded that structured awareness programs are effective tools for improving women’s understanding of cervical cancer, leading to better preventive behaviours and early detection

ABSTRACT Background Childhood leukaemia remains a major global health challenge and its impact varies significantly by region. Understanding the patterns of incidence, mortality, prevalence, and disability-adjusted life years (DALYs) is crucial for crafting effective public health initiatives and enhancing care outcomes, especially in regions with constrained resources. Methods This study evaluates the worldwide, regional, and country-specific effects of childhood leukemia between 1990 and 2021, leveraging data from the Global Burden of Disease (GBD) initiative. It delves into trends related to illness, death rates, prevalence, and DALYs across various income brackets and geographic areas, offering a comprehensive analysis of the disease's impact over three decades. Results Childhood leukemia rates have declined globally over the last 30 years, especially in high-income countries due to medical advancements. However, low- and middle-income nations face persistent challenges, as limited healthcare infrastructure, delayed diagnosis, and treatment accessibility contribute to a disproportionate burden. Across all regions, male children consistently bear a higher burden compared to females. Forecasts indicate the worldwide burden will decrease with enhanced treatment, yet disparities between affluent and poorer regions will persist. Conclusions While global trends indicate a reduction in the childhood leukemia burden, regional disparities remain. To further reduce the global burden, we must strengthen health systems, improve early detection and ensure access to treatment. To promote more equitable outcomes across regions, public health policies must focus on these areas.

One of the biggest causes of cancer-related fatalities among women is still Cervical cancer, especially in low and middle-income nations where access to broad screening and early detection may be limited. Cervical cancer is curable if detected in its early stages, but asymptomatic progression frequently results in late diagnosis, which makes treatment more difficult and lowers survival chances. Even though they work well, current screening methods including liquid-based cytology and Pap smears have drawbacks in terms of consistency, sensitivity, and specificity. Recent developments in Deep Learning and Artificial Intelligence have shown promise for greatly improving Cervical cancer detection and diagnosis. In this work, we have introduced CervixCan-Net, a novel Deep Learning based model created for the precise classification of Cervical cancer from histopathology images. Our approach offers a solid and dependable classification solution by addressing common problems like overfitting and computational inefficiency. CervixCan-Net performs better than many state-of-the-art models according to a comparison investigation. CervixCan-Net, with an impressive test accuracy of 99.83%, provides a scalable, automated Cervical cancer classification solution that has great promise for improving patient outcomes and diagnostic accuracy.

Nowadays, one of the leading widespread communicable health determinants of death globally is tuberculosis (TB), which is most prevalent in low-and middle-income nations where health systems consistently struggle with a lack of diagnostic and therapeutic resources (World Health Organization 2024). To address these issues, more digital health solutions are used, such as digital adherence technologies (DATs), video-observed therapy (VOT), artificial intelligence (AI)-enabled chest X-ray computer-aided detection (CAD), electronic surveillance, laboratory connectivity, and mobile financial incentives (Cattamanchi et al., 2021). While solutions like digital adherence technologies (DATs) and video-observed therapy (VOT) significantly enhance patient accessibility and participation in tuberculosis prevention, their efficacy in improving treatment outcomes remains variable (Subbaraman et al., 2018). The World Health Organization (WHO) authorised CAD as a triage method for tuberculosis screening, as it is as precise as radiography (Qin et al., 2021). When used in African contexts, connectivity technologies such as GxAlert reduce the time between diagnosis and the start of therapy (SystemOne, 2020). Besides, socioeconomic barriers to adherence are addressed through mobile money-based incentives, which have been investigated in TB programs in Africa (Krishnan et al., 2021). Additionally, long-term effectiveness, equity, compatibility, and coordination and regulation of digital health technologies remain enduring issues (Wingfield et al., 2020). The analysis highlights crucial perspectives and insights from current research, demonstrating the primary role of digital health applications in tuberculosis prevention in facilitating patient-focused, comprehensive care, distinct from alternatives to fundamental TB services (World Health Organization, 2024).

One of the most common infectious disease-related causes of death globally, particularly in low- and middle-income nations, persists: tuberculosis. At a manifestation of globalization, causes of death keep growing. As it happens, we have developed a sensor that quickly recognizes tuberculosis. The sensor operates in the (1–2 THz) frequency band, resulting in exemplary recognition and accuracy. Our present work asserts the design and numerical analysis of a hexagonal hollow-core photonic crystal fiber (HC-PCF) sensor for detecting tuberculosis (TB) cells adopting the finite element method (FEM) in COMSOL Multiphysics 6.1. This work highlights the synergy between advanced photonic sensor design and intelligent data analytics in next-generation healthcare technologies. The sensor operates at 1.6 THz and is optimized to achieve high relative sensitivity (RS), low confinement loss (CL), and minimal effective material loss (EML), critical parameters for effective biosensing. The proposed PCF has a maximum Relative Sensitivity of 95.28%, 95.34%, 95.41%, 95.46% & 95.53%, corresponding to refractive indexes (RI) of n = 1.345, 1.346, 1.347, 1.348 and 1.349; which are characteristic of TB-infected biological samples. CL values fall from 1.254 × 10−2 to 9.307 × 10−3 dB/m. EML varies from 0.00739 to 0.00713 cm−1 across this RI range, suggesting excellent light confinement and low propagation loss within the fiber structure. To further enhance detection accuracy and interpret complex sensor data, a machine learning approach using a Random Forest Regressor and Support Vector Regressor are applied. Those models are trained on the sensor’s optical responses, enabling precise prediction and classification of subtle refractive index changes associated with TB presence.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-27290-5.

Background Cervical cancer continues to pose a considerable global health concern, disproportionately impacting women in low- and middle-income nations due to various barriers. Although mostly preventable with immunization and screening, it ranks as the fourth most widespread cancer among women worldwide. Purpose The present study examines the capacity of poncirin to suppress viability and promote apoptosis in cervical cancer HeLa cells. Materials and Methods In this work, a 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide (MTT) test was utilized to study the effect of poncirin (5–160 µM) on the growth of HeLa cells. Apoptosis in the experimental HeLa cells was examined using a dual staining technique. The activities of caspase enzymes in the cells were evaluated using kits. Results The MTT assay findings indicated a substantial decrease in HeLa cell growth after treatment with poncirin. The findings of the dual staining test confirmed the initiation of apoptosis in the poncirin-treated HeLa cells. Moreover, the poncirin treatment significantly elevated caspase enzyme activities in the HeLa cells, thereby facilitating apoptotic induction. Conclusion The present findings indicate that poncirin treatment significantly inhibits growth and enhances caspase-mediated apoptotic cell death in HeLa cells. Consequently, it can serve as an anti-tumor candidate for the treatment of cervical cancer.

Background: Cardiovascular disease (CVD) continues to be the predominant cause of global mortality. Polypill techniques that integrate various cardiovascular drugs into a single formulation have emerged as a potential method for primary prevention, especially in intermediate-risk populations. Objective: To systematically review and synthesize evidence regarding the efficacy and safety of polypill formulations (comprising antihypertensive medications, statins, with or without aspirin) in comparison to standard care or placebo for the primary prevention of major adverse cardiovascular events (MACE) in intermediate-risk populations. Methods: We conducted systematic review and meta-analysis in accordance with PRISMA 2020 standards (Systematic Review Registration: PROSPERO CRD420251184718). Various databases (PubMed, Cochrane Library, ScienceDirect, Scopus) were examined for original research published from January 2015 to October 2024. Studies were eligible if they assessed polypill therapies in individuals aged 30 to 70 years with intermediate cardiovascular risk (10-20% 10-year risk), reported composite major adverse cardiovascular events (MACE) outcomes, and included a minimum follow-up of 6 months. Two independent reviewers conducted screening, data extraction, and risk of bias evaluation utilizing the Cochrane RoB 2.0 tool. Results: Of the 161 records discovered, 4 randomized controlled studies (HOPE-3, TIPS-3, PolyIran, PolyPars) with 31,501 people fulfilled the inclusion criteria. Polypill therapies showed a substantial decrease in composite MACE relative to control groups (pooled HR 0.67 (95% CI 0.60-0.75, p<0.001). Individual trial hazard ratios varied from 0.50 (PolyPars) to 0.66 (PolyIran) and 0.79 (TIPS-3) with moderate heterogeneity (I²=35.2%, p=0.20). Polypills were generally well- tolerated, with a safety profile consistent with the individual components. Medication adherence was enhanced with the polypill in comparison to multiple-pill regimens. Conclusions: Polypill techniques markedly reduce major adverse cardiovascular events (MACE) in intermediate-risk patients for primary cardiovascular prevention, achieving around a 33% relative risk reduction. The fixed-dose combination strategy provides benefits in compliance and ease of use. These findings hold significant implications for healthcare systems in low-to- middle-income nations, such as Indonesia, where the burden of cardiovascular disease is substantial and access to long-term cardiovascular drugs is frequently hindered by cost and complexity.

Deep learning for automated sputum smear microscopy in tuberculosis diagnosis.

Background:Globally, adolescent girls aged 15–19 years give birth to approximately 16 million children annually, accounting for 11% of all births. Low- and middle-income nations carry the burden of these births, with 95% happening in Africa, where maternal mortality rates continue to be high. In Sub-Saharan Africa, early marriages persist, with roughly half of women delivering before age 20.Objectives:This scoping review aimed to map evidence on the accessibility and barriers to maternal health services for adolescent girls in Sub-Saharan Africa.Eligibility criteria:Included studies were peer-reviewed articles published in English between 2014 and 2025, focusing on adolescent girls (10–19 years) and maternal health services in Sub-Saharan Africa.Sources of evidence:Literature searches were conducted in PubMed, Scopus, Web of Science, Directory of Open Access Journals and Google Scholar.Charting methods:The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Scoping Review extension guidelines. Data were extracted using a pre-designed template and analysed thematically. Results were synthesized narratively and presented in tables.Results:A total of 652 records were identified, with 26 articles included. Key findings indicate that financial constraints, stigma, geographical distance and restrictive policies are significant barriers to access. While most studies focused on accessibility, aspects of quality such as provider attitudes, adherence to guidelines and respectful care were less frequently and deeply explored, representing a significant evidence gap. Community-based programmes and youth-friendly services were identified as key facilitators. Unmarried adolescents and those with lower education levels faced compounded barriers.Conclusion:Given their reproductive health vulnerabilities, maternal health services targeting adolescents should be prioritized in Sub-Saharan Africa. Interventions must address both access barriers and critically improve service quality, including provider training in adolescent-sensitive care, though the current evidence base on quality-specific interventions is limited. Further research is needed to develop standardized metrics for quality care in this population.

This article investigates the interaction between economic growth and financial development in emerging and middle-income nations from 2000 to 2023 with a focus on the moderating role of institutional quality. Using panel data from the World Development Indicators, the IMF Financial Development Database, and the Worldwide Governance Indicators, the article examines the ways in which institutional strength mediates the growth benefit from financial development. The empirical analysis follows several stages: the Pedroni and Kao cointegration tests confirm the presence of a stable long-run interaction among the variables; the Pesaran–Yamagata (2008) test confirms slope heterogeneity; and unit root and cross-sectional dependency tests record mixed orders of integration and cross-country dependencies. The Cross-Sectionally Augmented Autoregressive Distributed Lag (CS-ARDL) estimates present that the institutional quality and the financial development exhibit significant and positive impacts in the long term on economic growth. In addition, the interaction effect between the two variables emphasizes the significance of well-performing institutional conditions in facilitating the growth effect from the growth in the financial sector. Conversely, trade openness only yields a weak positive effect, and inflation adversely influences growth. Overall, the estimates provide substantial policy directions for emerging and middle-income nations with the objective of creating inclusive, stable, and sustainable growth, with specific significance targeting the role of good institutions in efficient mobilization of the financial resources towards sustained economic growth.

This study assessed dental professionals' perceptions of the benefits, barriers, and educational strategies for digital dentistry in Southeast Asia, focusing on low- and middle-income nations. A questionnaire assessing perceptions of digital dentistry was developed and distributed via a multi-country survey of dental professionals in Southeast Asian countries. The questionnaire explored the perceived benefits of digital technologies, barriers to adopting digital workflows, and preferred methods for digital dentistry education. The survey included five-point Likert scale items and multiple-choice questions. Responses were collected anonymously online and stratified by country and participant characteristics. Statistical analyses included the Kruskal-Wallis test, Mann-Whitney U tests (with Bonferroni correction), and regression analyses (α = 0.05). Overall, 113 dentists from six Southeast Asian countries participated. Participants rated accuracy, productivity, and communication as key benefits. Most benefit ratings showed no significant cross-country differences except for profitability (p = .007). Clinical experience was positively associated with perceived communication benefits (p = .040). Cost was identified as the primary barrier to digital system adoption. Preferred educational methods included workshops, physical centers, and mentorships. A marginal association was observed between the country and likelihood of receiving on-site training (p = .065). Although expectations for the clinical value of digital dentistry were high across Southeast Asia, economic and infrastructural challenges remain significant barriers to adoption. Tailored education strategies should be developed considering each country's context and practitioner needs.

Cervical cancer continues to be a significant global health issue, especially in low- and middle-income nations, where late-stage diagnosis and elevated recurrence rates hinder treatment success. Thus, it is essential to identify trustworthy, accessible biomarkers to aid in the early detection of disease progression and recurrence. Among coagulation indicators, D-dimer a byproduct of fibrin breakdown has attracted growing interest for its possible clinical significance in cervical cancer. Increased D-dimer concentrations indicate hypercoagulability, tumor-related angiogenesis, and systemic inflammation, all of which are essential to cancer biology. This narrative review investigates the clinical significance of D-dimer in cervical cancer, assessing its function in risk stratification, tracking treatment response, and forecasting recurrence. We emphasize proof connecting high D-dimer levels to progressed disease stage, metastasis, and unfavorable prognosis, while also addressing its incorporation with imaging and additional hematological indicators to improve diagnostic precision. Issues like assay variability, absence of standardized cut-off values, and confounding factors influencing D-dimer levels are thoroughly assessed. Ultimately, we suggest future research avenues, such as validation studies, integration into predictive models, and investigation of D-dimer within multi-biomarker panels for precision oncology. Connecting coagulation science and oncology, D-dimer presents a potential supplementary marker to facilitate prompt interventions and enhance clinical results in cervical cancer. Peer Review History: Received 2 August 2025; Reviewed 9 September 2025; Accepted 17 October; Available online 15 November 2025 Academic Editor: Dr. Marwa A. A. Fayed, University of Sadat City, Egypt, maafayed@gmail.com Reviewers: Dr. Leyla Açık, Gazi University, Ankara, Turkey, leylaacik@gmail.com Dr. Lucky Llegbosi Nwidu, University of Port Harcourt, Nigeria, menelucky@yahoo.com

Childhood disability presents significant problems to health, development, and nutrition, particularly in low- and middle-income nations. There are more than 236 million disabled children all over the world, with a significant proportion in Sub-Saharan Africa. Disability prevalence in Kenya (11.4%) is similar to stunting (26%) and obesity (8%). Disabilities increase susceptibility to malnutrition because of feeding challenges, restricted mobility, frequent medical problems, and socio-economic factors. This study assessed the predictors of malnutrition in children with disabilities aged 6-59 months who presented themselves to Mbagathi County Referral Hospital, Nairobi. A hospital-based cross-sectional study comprising 160 children who had confirmed disabilities was conducted. The response was obtained by way of caregiver interviews, anthropometric data, and clinical data. The nutritional status was identified based on the WHO criterion of weight-for-age, height-for-age, weight-for-height, and mid-upper arm circumference (MUAC). The SPSS and Nutri-Survey were used to conduct data analysis, and chi-square and t-tests were used. Females were more likely to be severely malnourished and have oedema. Unemployment of caregivers (AOR=3.5), physical disability, recent illness and incomplete immunization, and feeding difficulties were predictors of underweight, while tertiary education was protective (AOR=0.41). Recent illness was found to be associated with stunting (AOR=2.5), but early breastfeeding discontinuation and deworming were protective (AOR=0.29 each). Unemployment of caregivers (AOR=3.1) and illness (AOR=2.4) were linked to wasting. This study proposed the use of specialized nutrition support, caregiver training, socioeconomic empowerment, and inclusive policies in low-resource urban areas.

Editorial: Quantitative ethnography in education research and evaluation in low- and middle-income nations

Background: Breast cancer is the primary cause of cancer-related deaths among women globally, with a particularly high incidence in low- and middle-income nations. In Brazil, disparities in access to diagnosis and treatment contribute to worse clinical outcomes, particularly in regions with a lower Human Development Index (HDI). This study evaluated the association between the delay between diagnosis and treatment initiation, and clinical outcomes of breast cancer across various Brazilian regions. Methods: This observational study utilized publicly available secondary data from the Department of Informatics of the Unified Health System (DATASUS), collected between 2013 and 2023. Data included age group, treatment type (surgery, chemotherapy, radiotherapy), and delay between diagnosis and treatment initiation (≤30 days, 31-60 days, >60 days). Regional disparities were analyzed according to the HDI. Statistical analyses were performed using GraphPad Prism 8.0.1, applying Pearson's correlation coefficient (r) and linear regression (R2) to assess associations between treatment delay and the number of cases or deaths. Results: Radiotherapy demonstrated the most significant negative correlation (r = -0.6624), and delays exceeding 60 days were consistently linked to poorer outcomes. In regions with lower Human Development Index (HDI), specifically the North and Northeast, longer treatment delays were observed, alongside a stronger correlation between delayed initiation of treatment and increased mortality. Conversely, shorter delays (30 days or less) demonstrated a weaker or absent correlation with improved outcomes. This suggests that other critical factors, such as the stage of cancer at diagnosis, the quality of care provided, and the consistency of treatment, are also significant determinants. Conclusions: Delays in treatment, particularly for radiotherapy and surgery, adversely affect breast cancer outcomes in Brazil. This impact is more pronounced in areas with lower Human Development Index (HDI), underscoring the critical need for targeted regional public policies. Such policies are essential to guarantee prompt diagnosis and treatment, thereby mitigating inequalities and enhancing survival rates.

Unsafe abortions contribute to approximately 8-11% of global maternal fatalities and predominantly occur in low- and middle-income nations. The Medical Termination of Pregnancy (MTP) Act enacted by the Indian Parliament in 1971, aimed at regulating and ensuring the accessibility of safe abortion services. Following the enactment of this legislation, a legal framework was established for abortion in India. This act delineates the circumstances under which abortion may be performed, the locations suitable for such procedures, and the qualified personnel authorized to carry them out. The World Health Organization (WHO) and the Federation of Obstetric and Gynecological Societies of India (FOGSI) have developed comprehensive guidelines for pre-abortion assessments, including the confirmation of pregnancy, accurate determination of gestational age, and validation of the intra-uterine location of the pregnancy. In spite of the relatively progressive abortion care services available in India, a significant number of women resort to self-medication with unsupervised over-the-counter (OTC) abortion pills for MTP. This practice results in a considerable incidence of unsupervised abortions and potentially life-threatening complications. We present herein a series of case reports documenting instances of OTC abortion pill consumption that led to morbidity and perilous situations, including near-miss cases that necessitated urgent medical and surgical interventions. Furthermore, we illustrate how our support and care have played a pivotal role in fostering resilience and faith in these women.