Background: Japan and South Korea, two advanced East Asian nations with universal health coverage and similar demographic challenges, have developed markedly different emergency medical services (EMS) systems. Despite growing interest in international benchmarking, structured, comparative studies that yield policy-relevant insights remain limited. Methods: We conducted a multisource comparative health-systems analysis using statutory laws, government publications, academic society reports, peer-reviewed literature, and national statistics. Key domains included EMS governance, workforce, prehospital organization, hospital-based emergency care, legal obligations for EMS patient transport and hospital acceptance, and governance and quality assurance mechanisms. Data were synthesized in comparative tables and narrative summaries to highlight structural and operational differences. Results: Japan’s EMS system operates under decentralized municipal control through 722 fire departments, serving 4,100 designated emergency institutions with 6,139 board-certified emergency physicians. In 2023, over 6.64 million ambulance dispatches occurred, and 8.6% were classified as critical cases (1.3% death and 7.3% severe). Korea’s EMS system is centrally governed with 412 designated facilities in a tiered system and 2,464 specialists. Annual ambulance activations exceeded 3.5 million, with severe cases accounting for approximately 5% to 10%. Japan employs a multilayered legal–institutional structure, primarily involving the Fire Service Act and the Medical Practitioners Act, allowing clinical discretion, whereas Korea enforces unified regulations with stricter obligations and criminal penalties for hospital refusal of emergency patients. Conclusion The contrasting systems suggest that hybrid governance that combines centralized standard settings with local operational flexibility may optimize EMS performance. These findings provide lessons for EMS reform, cross-border collaboration, and disaster preparedness in high-income nations facing similar demographic and healthcare challenges.

Epstein-Barr virus (EBV) was the first herpesvirus associated to human malignancies. Despite the well-known association between EBV and malignancies, the prevalence of EBV infection in Malaysians with malignancies is unknown. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to conduct a systematic review and metaanalysis of published data in this study. Studies reporting the occurrence of EBV infection in Malaysian malignancy patients were searched in electronic databases like PubMed, Scopus, ScienceDirect, and Google Scholar without year or language constraints. The study protocol was filed in PROSPERO (CRD42021273769). A total of 21 studies were included, with 1,036 EBV infection cases among 2,078 malignancy patients. The random-effects model was used to produce summary estimates. The pooled prevalence of EBV infection in Malaysians with malignancy was 36.3% (95% CI, 20.3 – 56.2). When the prevalence estimates were stratified by malignancy type, nasopharyngeal carcinoma has the highest prevalence (90.5%), followed by lymphoma (23.4%), and gastric carcinoma (10.0%). Male patients had a higher cases prevalence and most patients were above the age of 40. In Malaysia, many malignancies are increasingly linked to EBV infection. Screening for EBV infection in malignancy patients is therefore important to determine disease recurrence and metastases.

Chikungunya is an infection caused by chikungunya virus (CHIKV). Although chikungunya has affected many countries in recent times, specific treatment or licensed vaccine are nonexistent. In this study the potential antiviral properties of Tualang honey against in vitro CHIKV infection was evaluated. Cytotoxic test was performed using the XTT Cell Viability assay to determine maximum non-toxic dose (MNTD) in Vero cells. Using plaque assay, the potential antiviral activities of Tualang honey at various non-toxic concentrations and treatment regimens were evaluated. Tualang honey demonstrated virucidal effect with maximum inhibition CHIKV observed was 99.71% (p< 0.05). Tualang honey also had a prophylactic property by conferring protection to Vero cells during pre-treatment assay, resulting in up to 98.22% reduction of CHIKV replication under certain treatment regimen. Furthermore, Tualang honey exhibited anti-viral activities, with as much as 94.87% inhibition following post-treatment assay of Tualang honey in CHIKV-infected Vero cells. Additionally, Tualang honey also affected viral entry up to 82.21% after 48 hours of infection. These results suggest that Tualang honey has wide anti-CHIKV activities in Vero cells and exerts its effect through different mechanisms although these need to be further validated in other cells or model of CHIKV infection.