To investigate sexual health in breast cancer survivors and their partners, focusing on sexual satisfaction, changes in satisfaction with partner sexuality before vs. after the diagnosis, and unmet informational needs on sexual health in the context of breast cancer. Breast cancer patients and their partners were surveyed at a single time point 1-5 years after having completed primary therapy for breast cancer as part of a cross-sectional study. Study participants completed self-report-questionnaires covering personal characteristics, a question on satisfaction with partner sexuality before (retrospective assessment) versus after the diagnosis (based on the Sexual Medicine Questionnaire for Chronic Diseases (SFCE)), the EORTC (European Organisation for Research and Treatment of Cancer) Sexual Health Questionnaire (EORTC QLQ-SH22) together with the EORTC Quality of Life Core Questionnaire (EORTC QLQ-C30), and a questionnaire assessing sexual health care. Descriptive statistics were used to summarize demographic and clinical data. For group comparisons, dyadic dependencies were accounted for, applying paired t tests when normality (Shapiro-Wilk test) was met and Wilcoxon signed-rank test otherwise. A total of 128 participants (64 patients, 64 partners) were enrolled.Sexual satisfaction did not differ between patients (M = 55, SD = 20.9) and partners (M = 56.7, SD = 20) (t test, p = 0.46). A positive correlation was found between patients' and partners' sexual satisfaction (r = 0.62, p < 0.0001). Satisfaction with partner sexuality was lower after diagnosis (p < 0.001, r = 0.54)-with both patients and partners being less satisfied after the diagnosis (M = 2.58, SD = 0.95) than before (M = 3.14, SD = 0.74). Overall, 75% of the study participants reported not having received information about sexual health issues related to breast cancer, while 64% expressed a desire for more information. The findings of this study highlight the importance of considering couple dynamics in breast cancer care. Patients and partners have unmet needs concerning sexual health in the context of breast cancer. Addressing sexuality may improve quality of life and psychosocial adjustment. Future research should include larger, more diverse samples and focus on assessing sexuality and sexual health as multidimensional constructs in line with WHO (World Health Organization) definitions.

To describe the Appropriate Use of Cesarean Section Through Quality Decision-Making (QUALI-DEC) intervention-a multifaceted strategy to optimize the use of cesarean section in low- and middle-income countries-using the Template for Intervention Description and Replication (TIDieR) checklist to enable replication and scale-up. The QUALI-DEC intervention was implemented between July 2022 and April 2024 in 32 hospitals among Argentina, Burkina Faso, Thailand, and Viet Nam. Following the 12-item TIDieR checklist, we report in detail the four components of the intervention: (i) opinion leaders to promote evidence-based practices, (ii) audit and feedback using the Robson Ten Group Classification System, (iii) a Decision Analysis Tool to support informed decision-making by women, and (iv) companionship during labor and childbirth. Implementation processes, training, resources, and contextual adaptations were systematically documented. Opinion leaders were pivotal in training staff, leading audits, and sustaining implementation. Healthcare workers from participating facilities were trained in using clinical algorithms, the Ten Group Classification System, audit report forms, the Decision Analysis Tool, and the World Health Organization model of companionship. The intervention was coupled with online technology to facilitate training, data collection, and feedback loops. Overall, the QUALI-DEC intervention was feasible across diverse contexts, with variations reflecting local culture, infrastructure, and policy. Appropriate cesarean section use is shaped by women, providers, and organizational factors, making behavioral change complex. The QUALI-DEC intervention provided a pragmatic, team-based strategy to empower women and engage healthcare providers in evidence-based and patient-centered decision-making. Using the TIDieR checklist ensured a detailed description, supporting replication, implementation, and monitoring in other maternity units in low- and middle-income countries. ISRCTN67214403.

According to the World Health Organization, climate change is associated with detrimental health effects through air pollution, increased risk of infectious diseases, as well as extreme heat and drought. The rise in wildfires, exacerbated by climate change, plays a fundamental role in air pollution by emitting diverse pollutants responsible for adverse health effects, environmental and economic damage, directly impacting the health of populations, especially the most vulnerable. This study aimed to evaluate the effects on human health stemming from exposure to wildfire smoke in the Amazon region. For this purpose, a literature review following the PRISMA methodology was conducted in the Web of Science, PubMed, LILACS, and Scopus databases, with no restrictions for biological sex or time frame using descriptors such as "Exposure", "Health effect*", "Wildfire*", and "Air pollution". Articles in English, Spanish, and Portuguese were included. A total of 302 articles were identified, of which 30 met the inclusion and exclusion criteria. Studies were identified only in the Brazilian Amazon, and the groups most susceptible to smoke effects were children up to 5 years old and the elderly aged 60 and above, in addition to individuals with preexisting comorbidities. Only one article conducted a biomonitoring study in the region; the others worked with hospital admission data. Coordinated health actions are necessary to protect the health of exposed populations, especially those in conditions of social vulnerability, to ensure health protection and adequate environmental safety.

BACKGROUND Hydatid cyst disease of the liver remains a significant public health problem in endemic regions. While surgical treatment has traditionally been the mainstay of therapy, minimally invasive percutaneous approaches have emerged as safe and effective alternatives, especially for selected World Health Organization (WHO) cystic echinococcosis (CE) 1 and CE3a cysts. Comparative data on efficacy, complication rates, and clinical outcomes between the two methods are essential for guiding optimal treatment selection. AIM To compare and evaluate the efficacy, safety, complication rates, and clinical course of WHO CE1 and CE3a liver hydatid cysts treated with surgical and percutaneous methods. METHODS A total of 989 patients diagnosed with liver hydatid cyst and treated either surgically (n = 734) or percutaneously (n = 255) between 2005 and 2025 were included in the study. Demographic data, treatment process, complications, and recurrence rates of the retrospectively evaluated patients were recorded. Cyst volume, hospital stay duration, and catheter removal times were compared. Cases with and without fistula development were also analyzed separately. RESULTS There was no significant difference between the surgical (n = 734) and percutaneous (n = 255) groups in terms of gender (female: 76.0% vs 72.2%; P = 0.250) and age (38.4 ± 15.9 years vs 38.1 ± 16.1 years; P = 0.800), respectively. Operation time (85.6 ± 34.5 minutes vs 40.3 ± 15.7 minutes; P &lt; 0.001), hospital stay duration (7.3 ± 6.2 days vs 3.1 ± 2.3 days; P &lt; 0.001), catheter removal time (6.6 ± 5.3 days vs 5.5 ± 6.4 days; P = 0.014), and intraoperative organ injury rate (2.7% vs 0%; P = 0.002) were significantly longer/higher in the surgical group compared to the percutaneous group. Recollection was significantly more frequent in the percutaneous group (4.7% vs 1.2%; P = 0.001), as was anaphylaxis (1.6% vs 0.3%; P = 0.041). The rate of cysto-biliary fistula was similar in both groups [surgical 14.6% (n = 113), percutaneous 14.9% (n = 43); P = 0.902]. However, in patients with fistula, catheter removal time (surgical: 8.3 ± 4.9 days vs 5.9 ± 2.7 days and percutaneous: 17.8 ± 8.7 days vs 3.5 ± 2.9 days; P &lt; 0.001) and initial cyst volumes (surgical: 774.8 ± 513.2 mL vs 356.7 ± 95.6 mL and percutaneous: 700.9 ± 288.2 mL vs 346.5 ± 279.2 mL; P &lt; 0.001) were significantly higher compared to those without fistula. CONCLUSION For treatment of WHO CE1 and CE3a liver cysts, the percutaneous approach is a safe and effective method due to shorter hospital stays, minimal invasiveness, and negligible risk of intraoperative organ injury, whereas surgical methods appear marginally advantageous regarding recollection and anaphylaxis. In both groups, higher cyst volume increases the risk of fistula and may prolong the treatment process. Patient selection should consider these parameters.

High-grade meningiomas (HGMs) recurring after X-ray treatment show poor prognosis. We assessed the effectiveness and safety of boron neutron capture therapy (BNCT) in patients with refractory recurrent HGMs. This phase II investigator-led randomized controlled trial utilized an accelerator-based BNCT system to treat refractory recurrent HGMs. Patients were randomly assigned in a 2:1 ratio to the BNCT (12 patients) and control (6 patients) arms. Progression-free survival (PFS) judged by an independent third-party committee was the primary endpoint and PFS judged by the investigators and overall survival of the BNCT arm were the secondary endpoints. The control arm received rescue BNCT if they show disease progression. Three and two patients with World Health Organization (WHO) grade 3 disease were assigned to the BNCT and control arms, respectively; the remaining patients had WHO grade 2 disease. Median PFS (primary endpoint) was 14.4 months (95% confidence interval (CI): 7.9-26.4) in the BNCT arm and 1.4 months (95% CI: 1.0-9.0) in the control arm. Median PFS (secondary endpoint) was 14.7 months (95% CI: 7.6-22.8) in the BNCT arm and 1.5 months (95% CI: 1.0-9.0) in the control arm. The differences were statistically significant (log-rank test, P = 0.0157 and P = 0.0002, respectively). Five patients in the control arm received rescue BNCT. The objective response rate in the BNCT arm was 27.3%. BNCT is an effective treatment for refractory recurrent HMGs. Compared with conventional therapy, PFS in both primary and secondary endpoints were considerably improved.

Snakebite envenomation poses a significant threat to both public health and animal welfare, resulting in substantial human suffering and economic burden worldwide. Recognized by the World Health Organization as a neglected tropical disease, snakebites disproportionately affect impoverished rural regions across Africa, Asia, and South America, with an estimated 2.7 million envenomations and 81,000–138,000 deaths annually. In veterinary medicine, snakebites are similarly impactful, with up to 300,000 animals affected each year in the United States alone—primarily dogs and cats—while global veterinary cases likely number in the millions. Despite this, snakebites remain non-notifiable diseases, contributing to significant underreporting. The economic implications are profound, with treatment costs for human victims exceeding $200,000 per case and veterinary care ranging from $8,000 to $50,000 per case, often surpassing the financial capacity of pet owners. Beyond acute care, long-term sequelae such as chronic neuropathy and tissue damage further compound the burden. Current literature is limited in comparative analyses of envenomation mechanisms across species, particularly in livestock. This review will create a deeper understanding of pathophysiology, treatment modalities, and emerging therapies. Understanding of this background is essential to further advancements in science surrounding snake envenomation in both human and veterinary species.

Regular physical activity is an important factor in healthy aging. This cross-sectional study analyzed the association between lifelong physical activity and current quality of life and physical fitness in 220 people aged 60 years and over from 2010 to 2016. The subjects were divided into two groups based on World Health Organization (WHO) guidelines on physical activity: consistently active from a young age-active group (143 people) and inactive in their youth and currently-inactive group (77 people). The first two questions from the WHOQoL-BREF questionnaire (quality of life and self-assessment of health) assessed quality of life, and the Senior Fitness Test evaluated physical fitness. Additional data included handgrip strength, age, and gender. Physical activity differentiated lower (p = 0.003, η2 = 0.10) and upper limb strength (p = 0.004, η2 = 0.11), lower body flexibility (p = 0.024, η2 = 0.06), and aerobic capacity (p = 0.009, η2= 0.17) in women, indicating more favourable fitness outcomes in active women. In both gender groups, those who were active performed the 8-foot up-and-go test faster than those who were inactive (p = 0.002 in women and p = 0.033 in men, η2 = 0.32). No significant differences in quality of life were found between the active and inactive groups. Lifelong physical activity is associated with the physical fitness of older adults, especially older women. Our research confirms the need for further observation and analysis of quality of life, physical activity, and physical fitness among older adults.

Therapeutic drug monitoring (TDM) is a tool used for dose optimization to achieve therapeutic concentrations associated with improved outcomes. However, evidence supporting its benefits for tuberculosis (TB) treatment remains limited. This scoping review evaluated clinical studies on TDM and its impact on TB treatment outcomes. A scoping review was performed using a systematic search in PubMed, Embase, Web of Science, ClinicalTrials.gov, and the World Health Organization (WHO) Clinical Trials Registry for interventional and observational studies published until 3 May 2025. We included studies evaluating TDM in adults or children treated for drug-susceptible or drug-resistant TB at any setting worldwide, which reported treatment outcomes, adverse events, or clinical/microbiological surrogate markers. The PRISMA guidelines for scoping reviews were followed to report the findings. Of the 5820 studies screened by title and abstract, 31 studies from 10 countries were eligible for inclusion in this review. No published clinical trials on the implementation of TDM were identified, although two are currently ongoing. Overall, compared with the non-TDM group, TDM was associated with faster culture conversion (mean 34 versus 49 days), shorter treatment duration (mean 32 versus 36 weeks) and fewer adverse events. Although all included studies reported high treatment success rates (ranging from 67% to 100%), no statistically significant differences were observed in end-of-treatment outcomes between TDM and non-TDM groups. Dose adjustments guided by TDM were recommended by all included studies, despite variability in results. Observational data suggest that TDM in TB treatment was associated with improved effectiveness and fewer adverse events. However, further investigation through well-controlled studies is needed to minimize potential bias and justify its routine use.

Mycetoma is a chronic subcutaneous infection caused by fungi (eumycetoma) or filamentous bacteria (actinomycetoma). Although recently recognized by the World Health Organization as a neglected tropical disease, data from Southeast Asia are scarce. Previous reports from Thailand were limited and outdated. We conducted a 25-year retrospective study (2000-2025) at a tertiary referral hospital in southern Thailand. Patients were identified from hospital records and confirmed by histopathology and/or culture. Fifty patients met inclusion criteria: 31 (62%) had eumycetoma and 19 (38%) had actinomycetoma. The median age was 50 years (IQR 41.8-58.0), and 62% were male. The foot was the most common site (80%), with bone involvement in 28%. Sinus tracts occurred in 43%, but visible grains were recorded in only 12%. Histopathology (performed in 86%) reliably distinguished fungal from bacterial etiologies, whereas culture yield was low, especially for actinomycetoma (27%). Among eumycetoma, identified pathogens included dematiaceous fungi such as Exophiala jeanselmei and hyaline molds such as Scedosporium and Fusarium. Among the few culture-positive actinomycetoma cases, all isolates were Nocardia spp. Itraconazole was the main antifungal, whereas trimethoprim-sulfamethoxazole was used for actinomycetoma. Surgery was performed in 66% of patients. At a median follow-up of 21 months (IQR 7.5-46.0), 54% achieved cure, 24% improved, 10% recurrence, and 3% required amputation. Mycetoma in southern Thailand is uncommon but clinically significant. Unlike classical endemic regions, eumycetoma predominated and was caused by diverse fungi rather than Madurella mycetomatis. Despite combined medical and surgical therapy, cure rates were modest and complications frequent. These findings highlight regional differences in epidemiology and underscore the need for strengthened diagnostics, access to effective therapy, and region-specific neglected tropical disease strategies in Southeast Asia.

ABSTRACT Water quality is a stern issue in urban areas because it is indispensable for the sustenance of life. The present study aimed to determine the spatial trends with time in water quality attributed to transitioning anthropogenic land‐use/cover in a Himalayan city—Dehradun, India—through the Weighted Arithmetic Water Quality Index (WQI). A total of 36 samples from nine surface aquifers during four seasons were analyzed for physicochemical and biological water quality parameters and compared with standards prescribed by BIS—Bureau of Indian Standards and WHO—World Health Organization. The water quality categorization during the monsoon (good–moderate), post‐monsoon (poor–very poor), and the winter and premonsoon seasons (poor–unfit) reveals the temporal trends. Further, WQI values indicate that 25% of the water samples (urban) were in the very poor–unfit category, 52% in poor (semi‐urban), and 22.2% in good status (rural), with elevated values for Coliform bacteria at all locations. Unsustainable anthropogenic activities, namely, discharge of wastewater, indiscriminate dumping of solid waste, and fecal matter, are the main factors, which have negatively impacted the water quality of these rivulets. Land‐cover analyses from 2002 to 2023 observed an increase in settlement—urban built‐up (+7.5%), cultivated land (+7.5%), and barren land (+4.4%), whereas grassland (−8%), forest (−12%), and water bodies (−0.11%) decreased in terms of area coverage, with a slight decline in land surface temperature regimes attributed to the aerosol optical depth variations. The management of water resources (catchment basin conservation) in the Dehradun region is a major concern pertaining to urban land use planning and the mandate of Sustainable Development Goals (SDGs) 6 and 11.

Monkeypox (mpox) is an emerging orthopoxviral disease that has re-emerged globally since 2022, with over 163,000 confirmed cases reported across multiple World Health Organization regions. Mpox has two large clades; Clade I which is mostly related to Central Africa and more severe disease and Clade II which has caused recent multinational outbreaks and is represented by the B.1 lineage. This review is an overview of the existing findings on the pathogenesis of mpox, viral evolution, immune evasion strategies, and the protective efficacy of smallpox and third-generation mpox vaccines based on epidemiological, clinical, immunological, and vaccine-related literature published in leading biomedical databases. Recent evidence suggests that mpox has several immune evasion mechanisms that interrupt innate and cellular immune responses, allowing prolonged human-to-human infection. High risks populations are disproportionately affected by the disease especially men who have sex with men and people living with HIV who become more susceptible, and severity of the disease worsens. Previous smallpox vaccination offers a significant level of cross-protective immunity, with aggregate evidence indicating that it offers protection of about 80 percent and a considerably lower risk of becoming infected. Third-generation vaccines such as MVA-BN/JYNNEOS, are showing good safety profiles, moderate to high efficacy in comparison to older vaccines like the ACAM2000, with other platforms being under clinical development. Knowledge of clade-specific viral evolution, immune resistance and vaccine efficacy is crucial to the optimization of vaccination response, the prioritization of susceptible population, and preparedness to future outbreaks of ortho poxvirus.

Introduction: Anaemia in pregnancy remains a public health problem and is an important indirect cause of maternal mortality. Iron deficiency is regarded as the most common cause of anaemia during pregnancy. World Health Organization recommends daily oral iron and folic acid (IFA) supplementation as part of antenatal care. Despite this recommendation, the use of IFA supplements is still very low in several developing countries. Objectives: To determine the prevalence of consumption of IFA supplements and to identify its determinants among women while pregnant. Methods: It was a population based cross sectional study done in rural field practice area of community medicine. Total of 370 mothers of two months to two years old children were selected by PPS sampling. Data so collected was analysed by SPSS using descriptive inferential and chi square test. Results: Prevalence of IFA consumption for 180 days or more was 56.7%. Factors like caste, socioeconomic status of family, education of respondent as well as husband, parity and knowledge about antenatal care, anaemia and IFA consumption were significantly associated with consumption of IFA supplements. Side effects, forgetfulness and lack of knowledge about duration of intake were main reasons for discontinuation. Conclusion: There is a need to generate awareness regarding importance and correct duration of IFA consumption during pregnancy and constant mobilisation and support by health workers is required to increase the compliance

Ageing is a dynamic biological process involving interconnected physiological, psychological, and social changes, making the promotion of healthy ageing a global public health priority. The World Health Organization (WHO) defines healthy ageing as the process of developing and maintaining functional ability that enables well-being in older age. The WHO’s Decade of Healthy Aging (2021–2030) outlines four key action areas: changing attitudes toward ageing, creating age-friendly environments, delivering integrated and person-centred care, and ensuring access to long-term care. This Perspective examines yoga, a holistic mind–body practice integrating physical postures, breath regulation, and mindfulness, as a potentially safe, adaptable, and scalable intervention for older adults. Evidence suggests that yoga may improve flexibility, balance, mobility, and cardiovascular function, reduce pain, and support the management of chronic conditions commonly associated with ageing. Psychological and cognitive research further indicates reductions in stress, anxiety, and depressive symptoms, alongside potential benefits for attention, memory, and executive function. Improvements in health-related quality of life (HRQoL) have been reported across physical, psychological, and social domains, with benefits sustained through regular practice. Adaptations such as chair-based practices, restorative postures, and the use of props enhance accessibility and safety, allowing participation across diverse functional levels. Mindfulness and breath-focused components of yoga may additionally support emotional regulation, resilience, and psychological well-being, particularly among older adults experiencing stress or limited mobility. Yoga interventions are generally well tolerated, demonstrate high adherence, and can be delivered through in-person and digital formats, addressing common access barriers. Despite this growing evidence base, yoga remains underintegrated within health policy and care systems in the US, UK, and India. Strengthening its role may require coordinated efforts across research, policy, and implementation to support healthy ageing outcomes.

People diagnosed with advanced HIV disease (AHD) should be provided with the World Health Organization's (WHO) package of care to address their specific healthcare needs. Although the WHO-recommended package of care is considered feasible and effective, its implementation remains sub-optimal across many sub-Saharan African (SSA) countries. This study aimed to explore challenges in implementing the WHO-recommended package of care for advanced HIV disease in resource-constrained settings. A sequential explanatory mixed-methods study was conducted between March 1 and April 30, 2024, in the Gedeo Zone of Southern Ethiopia. The quantitative data involved extraction from medical records of 145 individuals newly diagnosed with AHD. For the qualitative inquiry, healthcare providers engaged in the HIV care continuum were purposively selected for in-depth key informant interviews. An inductive thematic analysis was conducted to identify and interpret recurrent patterns within the qualitative data. Quantitative data were analyzed using R version 4.3.3, while qualitative data were organized and managed using NVivo version 14. Only about half (47.6%) of the newly diagnosed AHD cases underwent baseline CD4 count testing. All 145 individuals were screened for TB using the WHO four-symptom algorithm, and 78.6% underwent confirmatory GeneXpert® MTB/RIF testing. Among individuals with AHD, 92.4% received co-trimoxazole prophylaxis, and 14.5% received tuberculosis preventive therapy. Rapid ART initiation was implemented for 20.0% of individuals with AHD. All newly diagnosed individuals with AHD received tailored counseling to ensure optimal adherence. Qualitative data analysis identified three principal challenges to the implementation of the WHO-recommended package of care: structural and organizational obstacles, service delivery constraints, and patient-related concerns as expressed by healthcare workers. The implementation of the WHO-recommended package of care for individuals with AHD remains inconsistent. Although adherence support is routinely offered to all newly diagnosed individuals with AHD, the delivery of other key components is frequently hindered by a range of systemic challenges. These include the unavailability or frequent stockouts of essential medications and services for managing opportunistic infections, weak referral and linkage systems, and the absence of dedicated AHD care clinics. Such challenges underscore significant gaps in the continuum of AHD care and highlight the pressing need for targeted, system-level interventions to ensure comprehensive service delivery.

BackgroundPeople diagnosed with advanced HIV disease (AHD) should be provided with the World Health Organization’s (WHO) package of care to address their specific healthcare needs. Although the WHO-recommended package of care is considered feasible and effective, its implementation remains sub-optimal across many sub-Saharan African (SSA) countries. This study aimed to explore challenges in implementing the WHO-recommended package of care for advanced HIV disease in resource-constrained settings.MethodsA sequential explanatory mixed-methods study was conducted between March 1 and April 30, 2024, in the Gedeo Zone of Southern Ethiopia. The quantitative data involved extraction from medical records of 145 individuals newly diagnosed with AHD. For the qualitative inquiry, healthcare providers engaged in the HIV care continuum were purposively selected for in-depth key informant interviews. An inductive thematic analysis was conducted to identify and interpret recurrent patterns within the qualitative data. Quantitative data were analyzed using R version 4.3.3, while qualitative data were organized and managed using NVivo version 14.ResultsOnly about half (47.6%) of the newly diagnosed AHD cases underwent baseline CD4 count testing. All 145 individuals were screened for TB using the WHO four-symptom algorithm, and 78.6% underwent confirmatory GeneXpert® MTB/RIF testing. Among individuals with AHD, 92.4% received co-trimoxazole prophylaxis, and 14.5% received tuberculosis preventive therapy. Rapid ART initiation was implemented for 20.0% of individuals with AHD. All newly diagnosed individuals with AHD received tailored counseling to ensure optimal adherence. Qualitative data analysis identified three principal challenges to the implementation of the WHO-recommended package of care: structural and organizational obstacles, service delivery constraints, and patient-related concerns as expressed by healthcare workers.ConclusionsThe implementation of the WHO-recommended package of care for individuals with AHD remains inconsistent. Although adherence support is routinely offered to all newly diagnosed individuals with AHD, the delivery of other key components is frequently hindered by a range of systemic challenges. These include the unavailability or frequent stockouts of essential medications and services for managing opportunistic infections, weak referral and linkage systems, and the absence of dedicated AHD care clinics. Such challenges underscore significant gaps in the continuum of AHD care and highlight the pressing need for targeted, system-level interventions to ensure comprehensive service delivery.

Long-term exposure to fine particulate matter (PM2.5) contributes to about 8 million premature deaths worldwide annually. In Türkiye, few studies have examined long-term health impacts, particularly during and after the coronavirus disease-2019 (COVID-19) pandemic. This study aimed to estimate premature mortality and the respiratory disease burden attributable to PM2.5 from 1 January 2019 to 31 December 2023. Premature deaths attributable to PM2.5 were estimated using the World Health Organization's (WHO) AirQ+ software. Inputs included annual provincial PM2.5 concentrations (measured directly or at stations without PM2.5 measurements, converted from PM10 using the WHO-recommended factor of 0.67 for Türkiye), mortality data for individuals aged ≥25 years, and demographic data from Turkish Statistical Institute. The Estimates focused on chronic obstructive pulmonary disease (COPD) and lung cancer. Population attributable fractions were calculated. Temporal comparisons were made across pre-pandemic (2019), pandemic (2020-2021), and post-pandemic (2022-2023) periods to capture potential effects of COVID-19-related reductions in industrial production and traffic. Differences were assessed using one-way ANOVA. An annual average of 85,344 premature deaths (95% confidence interval: 79,129-91,559) was attributable to PM2.5. COPD and lung cancer accounted for a significant share of PM2.5-related deaths, with about one in seven linked to COPD. Although temporary improvements in air quality occurred during the COVID-19 pandemic, no statistically significant difference was observed in COPD-attributable mortality across the three study periods (P = 0.687). Air pollution remains a major public health challenge in Türkiye. Sustained, region-specific strategies are needed to reduce the burden of PM2.5-related mortality. Inadequate monitoring coverage continues to limit precision in exposure and risk assessment.

BACKGROUND Drug utilization research has an important role in assisting the healthcare administration to know, compute, and refine the prescription whose principal objective is to enable the rational use of drugs. Research in developing nations relating to the cost of treatment is scarce when compared with developed countries. Thus, the drug utilization research studies from developing nations are most needed, and their number has been growing. AIM To evaluate patterns of utilization of antipsychotic drugs and direct medical cost analysis in patients newly diagnosed with schizophrenia. METHODS The present study was observational in type and based on a retrospective cohort to evaluate patterns of utilization of antipsychotic drugs using World Health Organization (WHO) core prescribing indicators and anatomical therapeutic chemical/defined daily dose indicators. We also calculated direct medical costs for a period of 6 months. RESULTS This study has found that atypical antipsychotics are the mainstay of treatment for schizophrenia in every age group and subcategories of schizophrenia. The evaluation based on WHO prescribing indicators showed a low average number of drugs per prescription and low prescribing frequency of antipsychotics from the National List of Essential Medicines 2015 and the WHO Essential Medicines List 2019. The total mean drug cost of our study was 1396 Indian rupees. The total mean cost due to the investigation in our study was 1017.34 Indian rupees. Therefore, the total mean direct medical cost incurred on patients in our study was 4337.28 Indian rupees. CONCLUSION The information from the present study can be used for reviewing and updating treatment policy at the institutional level.

Mother-to-child transmission (MTCT) is a primary source of hepatitis B virus (HBV) infection in endemic regions. The World Health Organization (WHO) aims to reduce HBV seroprevalence among children under five to less than 0.1% by 2030. In Malaysia, the seroprevalence of hepatitis B surface antigen (HBsAg) in children has declined to 0.4%, but additional measures are needed. A pilot study in Sarawak, Malaysia, screened 474 pregnant women for HBsAg. Those with high MTCT risk received tenofovir disoproxil fumarate from 28 weeks of gestation to 12 weeks postpartum. Infants received timely birth-dose HBV vaccine and hepatitis B immunoglobulin (HBIG) where indicated. Among screened women, 1.9% were HBsAg positive, with 55.6% newly diagnosed. No MTCT cases were observed. Risk factors included maternal age over 35, household exposure, and sexual transmission risk. These findings demonstrate the feasibility of WHO's PMTCT strategies in low-resource settings, supporting nationwide expansion in Malaysia.

Nipah virus (NiV) is recognised as a priority pathogen with pandemic potential by the World Health Organisation (WHO). The NiV-Bangladesh strain (NiV-B) has been associated with recent outbreaks in different districts of Bangladesh and the state of Kerala (India), and it is suggested to be more pathogenic and lethal than the NiV-Malaysian strain (NiV-M). In this study, we aimed to describe the clinical signs and pathology of NiV-B using the golden Syrian hamster model following intranasal (IN) and intraperitoneal (IP) inoculation with different doses and to compare with prior NiV-M results. For this purpose, we selected samples from NiV-B-infected animals that were submitted for H&amp;amp;E evaluation, immunohistochemistry (IHC), in situ hybridisation (ISH) (RNAscope technique), and multiplex immunofluorescence (mIF). The absence of neurological signs was observed in NiV-B-infected animals compared with those that were NiV-M-infected. Except for the brain, which did show only mild lesions, histopathological analysis of NiV-B demonstrated similar pathology and viral RNA in the lung, spleen, and liver compared to those of NiV-M infected animals, with the lung being the main affected organ. Pulmonary lesions consisted of areas of broncho-interstitial pneumonia associated with high cell death activation (caspase-3), proliferation (Ki67), and abundant intralesional macrophages (Iba1) and T cells (CD3). Differential upregulation of the cytokine IL-6 was observed in the lung from NiV-B compared with NiV-M infected animals. Moreover, we demonstrated the wide distribution of the NiV receptor ephrin B2 in endothelial cells, neurons, smooth muscle, epithelial cells, macrophages/type II pneumocytes, and T cells.

Melanocytic nevi display numerous clinical and histopathologic variants that may create diagnostic uncertainty. Forms such as halo nevi, Meyerson nevi, Spitz nevi, recurrent nevi, blue nevi, special-site nevi, and hormonally influenced nevi may exhibit features suggestive of malignancy, yet none of these characteristics alone imply malignancy. Histopathologic findings such as asymmetry, pagetoid spread, cytologic atypia, or dermal mitoses therefore require interpretation within the clinicopathologic context. Acomplete excision in toto is of particular importance, as superficial shave biopsies may alter or destroy characteristic architectural patterns and increase the risk of misinterpretation. In addition to classic nevus subtypes, diagnostic borderline lesions (e.g., SAMPUS [superficial atypical melanocytic proliferation of uncertain significance]; MELTUMP [melanocytic tumor of uncertain malignant potential]; MANIAC [melanocytic acral nevus with intraepidermal ascent of cells]) are discussed. The updated World Health Organization classification has introduced the category of melanocytoma, encompassing tumors with intermediate biological potential that may be more clearly delineated through molecular diagnostics. This article provides practical insight into the relevance of clinical information, key histopathologic criteria, and ancillary immunohistochemical and molecular studies as the foundation for diagnostic accuracy and structured management at the interface of dermatology and dermatopathology.