Hepatitis D virus （HDV） infection， the most severe form of viral hepatitis， remains underrecognized in the Asia due to inconsistent screening and limited surveillance. This systematic review （1970—2025） stratified HDV prevalence by population subgroups： community， hospital-based， and high-risk.Community studies showed high prevalence in Pakistan， Kazakhstan， and Kyrgyzstan； hospital cohorts revealed hyperendemicity in Mongolia and Uzbekistan； high-risk populations showed concentrated transmission in ［Hong Kong， China］， ［Taiwan， China］， Vietnam， and Sultanate of Oman. Many countries and regions lacked subgroup-specific data.The uneven， population-dependent burden underscores HDV as a major driver of advanced liver disease in Central and South Asia. Routine HDV screening and RNA-based diagnostics are essential to define burden and advance WHO 2030 elimination targets.¹

Background: Mice are useful small animal models to study the pathogenesis of SARS-CoV-2 infection. As the ancestral SARS-CoV-2 strains did not utilize murine Ace2 as a receptor, wild-type mice were not susceptible to the SARS-CoV-2 infection. Infection of human ACE2-expressing transgenic mice with SARS-CoV-2 induces fatal encephalitis, which is not commonly observed in humans. We and others have previously demonstrated the ability of the SARS-CoV-2 Beta variant to productively infect wild-type mice. Herein, we employed RNA-seq to investigate the transcriptomic landscapes in the lungs after the infection of wild-type mice with SARS-CoV-2 Beta variant. Methods: We intranasally infected 6-week-old wild-type C57BL/6J mice with the SARS-CoV-2 (B.1.351 strain) and collected lungs at 3- and 6-days post-infection for RNA-sequencing. We used the Limma-Voom package to identify differentially expressed genes (DEGs) and the fgsea package for pathway enrichment analysis. We used Cytoscape to identify hub genes and gene networks. Lastly, we employed RT-qPCR and multiplex assay to validate the RNA-seq data. Results: Using a cutoff of an adjusted p-value below 0.05 and an absolute log2 fold change value greater than 0.75, we identified 285 DEGs on day 3 and 46 DEGs on day 6. The canonical pathways analysis showed that several key pathways such as apoptosis and cytokine response were upregulated in the infected lungs. Protein-protein interaction analyses identified innovative target genes such as if11, Ccna2, and Aurkb. We also identified the top 10 hub genes that included Prc1, Ube2c, Ccnb2, Ncapg, Aurkb, Cep55, Mki67, Dlgap5, Ccna2, and Kif11. RT-qPCR analysis for Tnfa, Il6, Ccl2, and Ccl3 further validated the RNA-seq analysis. Consistent with gene expression results, we detected significantly increased protein levels of various inflammatory mediators such as IL-6, CCL2, CXCL2, and CXCL10 in the infected lungs. Conclusions This is the first transcriptomic analysis of the lungs of wild-type mice infected with a clinical isolate of SARS-CoV-2. Our findings provide a further understanding of the pathogenic events that occur in this mouse model of SARS-CoV-2 infection.

Objective: Organic compounds present in environmental pollution are currently regarded as major health threats. Phenanthrene (Phe), a polycyclic aromatic hydrocarbon, impairs testicular function through oxidative stress, leading to the failure of spermatogenesis. This study aimed to explore the potential beneficial effects of photobiomodulation (PBM) on testicular tissue and sperm parameters following Phe exposure in mice. Methods: Twenty-four adult male mice, aged 8 weeks, were randomly divided into three groups: control, Phe, and Phe+PBM. In the Phe and Phe+PBM groups, mice received Phe (500 ng/kg) via gavage every 48 hours for 5 weeks. Following Phe exposure, the testes of the Phe+PBM mice were irradiated with laser photons every other day for 35 days. After euthanasia, epididymal tails and testes were collected for molecular and histological analyses. Results: PBM significantly improved sperm count, motility, and viability (p<0.0001). Moreover, reactive oxygen species production, lipid peroxidation, and apoptosis were markedly reduced in the testicular tissue of the laser-treated mice (p<0.0001). Improvements were also observed in seminiferous epithelium thickness and cell distribution following PBM (p<0.0001). Conclusion Laser therapy significantly mitigates testicular damage from Phe exposure by reducing oxidative stress and apoptosis biomarkers, thereby improving testicular tissue and sperm parameters.

Objective: Cyclophosphamide (CP), a chemotherapeutic agent, has been shown to inhibit spermatogenesis. Accordingly, the primary objective of this study was to evaluate the potential therapeutic benefits of quercetin‑loaded nanoselenium (quercetin‑loaded selenium nanoparticles [SeNPs]) in mice treated with CP. Methods: Thirty‑five adult male mice were randomly assigned to five groups (n=7 per group): control, quercetin‑loaded SeNPs (20 mg/kg, daily for 5 weeks), CP (200 mg/kg, single dose), treatment A (CP+quercetin‑loaded SeNPs), and treatment B (CP+quercetin, 20 mg/kg daily for 5 weeks). Sperm parameters, DNA fragmentation index, catalase activity, levels of glutathione (GSH), glutathione disulfide (GSSG), malondialdehyde (MDA), and reactive oxygen species (ROS) were evaluated in all groups, along with histological assessments of testicular tissue. Results: In CP‑treated mice, administration of quercetin‑loaded SeNPs (treatment A) significantly improved sperm parameters, including total count, motility, morphology, and DNA integrity. Treatment also markedly increased the numbers of spermatogonia, primary spermatocytes, spermatids, Sertoli cells, and Leydig cells in testicular tissue. Furthermore, treatment with quercetin‑loaded SeNPs resulted in a significant increase in catalase activity and GSH levels while significantly reducing GSSG, MDA, and ROS levels in CP‑induced testicular damage. Conclusion These findings suggest that quercetin‑loaded SeNPs enhance spermatogenesis in a CP‑induced mouse model by improving the antioxidant profile and testicular stereological parameters.

A 57-year-old woman with diabetes and hypertension presented with acute calculous cholecystitis and cholangitis. Incidentally, two splenic lesions were identified on formal abdominal ultrasound, one demonstrating the sonographic bright band sign. Computed tomography confirmed splenic infarctions and also revealed portosplenic vein thrombosis. Haematological workup, including JAK2 V617F mutation analysis, led to a diagnosis of polycythaemia vera, contributing to cholelithiasis via increased cell turnover and thrombosis due to hyperviscosity. She was started on venesection and hydroxycarbamide and discharged well. However, she defaulted follow -up and re -presented two years later with disseminated intravascular coagulation, eventually succumbing to the illness. This case highlights the utility of the sonographic bright band sign in identifying splenic infarction and distinguishing it from other hypoechoic splenic lesions

Case Report Open Access 15 Primary sternal osteosarcoma is an exceptionally rare entity with a male preponderance. We report a rare case of a 19 -year-old nulliparous female who presented with a two -year history of a progressively enlarging right breast mass. Multimodality imaging —including chest radiography, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) revealed a large mass arising from the sternum extending into the right breast and anterior mediastinum. Biopsy confirmed high - grade osteosarcoma, characterised by multinucleated giant cells and stromal cells with mild atypia. Immunohistochemistry was positive for vimentin and negative for CK7. Surgical resection was planned; however, the patient declined treatment. This case highlights the importance of considering rare diagnoses in atypical presentations of breast masses and underscores the value of imaging and histopathological correlation in diagnosis and management

A 57-year-old woman with diabetes and hypertension presented with acute calculous cholecystitis and cholangitis. Incidentally, two splenic lesions were identified on formal abdominal ultrasound, one demonstrating the sonographic bright band sign. Computed tomography confirmed splenic infarctions and also revealed portosplenic vein thrombosis. Haematological workup, including JAK2 V617F mutation analysis, led to a diagnosis of polycythaemia vera, contributing to cholelithiasis via increased cell turnover and thrombosis due to hyperviscosity. She was started on venesection and hydroxycarbamide and discharged well. However, she defaulted follow -up and re -presented two years later with disseminated intravascular coagulation, eventually succumbing to the illness. This case highlights the utility of the sonographic bright band sign in identifying splenic infarction and distinguishing it from other hypoechoic splenic lesions

Case Report Open Access 15 Primary sternal osteosarcoma is an exceptionally rare entity with a male preponderance. We report a rare case of a 19 -year-old nulliparous female who presented with a two -year history of a progressively enlarging right breast mass. Multimodality imaging —including chest radiography, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) revealed a large mass arising from the sternum extending into the right breast and anterior mediastinum. Biopsy confirmed high - grade osteosarcoma, characterised by multinucleated giant cells and stromal cells with mild atypia. Immunohistochemistry was positive for vimentin and negative for CK7. Surgical resection was planned; however, the patient declined treatment. This case highlights the importance of considering rare diagnoses in atypical presentations of breast masses and underscores the value of imaging and histopathological correlation in diagnosis and management

Introduction: Accurate diagnosis of thyrotoxicosis, a condition resulting from excessive thyroid hormone activity, is essential for appropriate management. However, access to diagnostic tools such as thyrotropin receptor antibody (TRAb) assays and thyroid ultrasonography remains limited in resource-constrained settings, highlighting the need for cost-effective alternatives. Recent studies suggest that the free triiodothyronine to free thyroxine (FT3/FT4) ratio may serve as a potential biomarker for differentiating the causes of thyrotoxicosis. Methodology: This cross-sectional study evaluated the FT3/FT4 ratio in newly diagnosed thyrotoxicosis patients aged ≥18 years recruited from Hospital Tengku Ampuan Rahimah, Hospital Banting, Klinik Kesihatan Pelabuhan Klang, and Klinik Kesihatan Pandamaran between February and December 2025. All participants underwent thyroid function testing (FT3, FT4, and TSH) and autoantibody assessment (TRAb and anti-thyroid peroxidase [anti-TPO]). Diagnostic performance of the FT3/FT4 ratio for Graves’ disease was assessed using receiver operating characteristic (ROC) curve analysis. Results: Fifty-eight patients were included, of whom 58.6% were diagnosed with Graves’ disease. Patients with Graves’ disease had significantly higher FT3 levels (median 16.8 pmol/L; IQR 10.9–25.7) compared to those with non-Graves’ thyrotoxicosis (median 8.3 pmol/L; IQR 5.3–13.5; p <0.001), with similar trends observed for FT4 levels (p <0.001). However, the FT3/ FT4 ratio did not differ significantly between groups (p >0.05), with an overall ROC AUC of 0.572, indicating poor discriminatory ability. Subgroup analysis based on FT4 levels improved performance; at FT4 <30 pmol/L, the FT3/FT4 ratio demonstrated 75.0% sensitivity, 91.7% specificity, and 87.5% diagnostic accuracy at a cutoff of 0.3445 (AUC = 0.813; 95% CI: 0.570–1.000; p = 0.069). No significant association was observed between the FT3/FT4 ratio and TRAb or anti-TPO. Conclusion The FT3/FT4 ratio has limited overall diagnostic utility but may provide adjunctive value in selected biochemical contexts, particularly in settings with limited access to immunological testing.
Diagnosis, Differential ; Thyroxine ; Triiodothyronine ; Thyrotoxicosis ; Cross-Sectional Studies

Hemorrhage is a prevalent side effect of various injuries and can be life-threatening in certain instances. It is categorized into compressible and non-compressible types, each necessitating distinct modeling, laboratory assessments, and hemostatic approaches. This study utilized the keywords Hemorrhage, Bleeding, Animal Modeling, and Hemostat in reputable databases. The findings indicate that femoral artery hemorrhage and hepatic parenchymal hemorrhage are the predominant modeling techniques for compressible and noncompressible bleeding, respectively. Furthermore, it is noted that animal models of compressible hemorrhages are primarily situated in superficial body areas to investigate dressing or additive hemostats, while non-compressible hemorrhage models, typically located in visceral organs, are employed to examine adhesive or surgical instrumentbased hemostats.