The growing complexity of death and dying in Intensive Care Units highlights nurses' critical role, particularly concerning family interactions and spiritual needs from an Islamic perspective. However, there is a gap in understanding the nuances of these interactions, how nurses can best facilitate them, and how potential conflicts arising from differing interpretations of religious beliefs may impact care; this area remains underexplored. This systematic literature review aims to synthesize existing studies on ICU nurses' experiences with critically ill patients during death and dying, focusing on Islamic perspectives or spiritual care, employing a qualitative synthesis approach. The Scopus database was used to retrieve relevant documents published between 2005 and 2024. The review followed PRISMA guidelines for identification, screening, exclusion, and inclusion. Qualitative, quantitative, mixed-method studies, and review articles were included, with only qualitative papers appraised using the Joanna Briggs Institute’s criteria. Initially, 378 records were identified. After removing unavailable files and screening, 113 titles and abstracts were assessed. Of 84 reports reviewed for eligibility, 68 were excluded, leaving 14 studies that met the inclusion criteria for the final review. This review emphasizes the crucial need for better training, policies, and institutional support for ICU nurses. Such measures would enable them to manage the complexities of culturally sensitive care for family members during loved ones' death and dying. Implementing standardized guidelines addressing Islamic perspectives can significantly improve care quality and patient-family satisfaction.

Nursing education has undergone a significant transformation as a result of artificial intelligence (AI). Chatbots, specifically ChatGPT, have emerged as vital AI technologies within the nursing domain as it is a computer program designed to simulate human conversation through text or voice interactions. This study aims to conduct a bibliometric analysis to gain insights into the publication trends, citation impact, and thematic evolution in nursing education and practice concerning ChatGPT and chatbots. A comprehensive bibliometric analysis was performed using VOSViewer, concentrating on citation networks for data analysis and visualisation. A review of LENS.org identified 344 relevant research publications regarding chatbots and ChatGPT within the nursing discipline, all of which were utilised in the study. The study examined various aspects, including types of publications, prominent authors, leading journals, participating nations, institutions, and the impact of ChatGPT on nursing practice. The primary objectives included categorising the papers, identifying the most influential authors, delineating the prominent areas and institutions in the field, and examining the impact of ChatGPT on nursing education and practice. The findings indicate that ChatGPT positively impacts nursing education by enhancing learning experiences, improving communication, and aiding clinical decision-making. The findings indicate that journal articles accounted for 76% of publications, with the U.S. leading in research output. The findings indicate that ChatGPT positively impacts nursing education by enhancing learning experiences, improving communication, and aiding clinical decision-making. Future research should focus on establishing frameworks for integrating ChatGPT into nursing education, addressing ethical implications, and assessing the long-term impacts on patient care.

Spirulina, a small blue-green algae that lives in warm, alkaline seas, is one of the world's oldest life forms. With century-old history, this nutrient-rich organism has received a lot of interest in recent years for its possible health benefits and sustainable production practices. Studies have indicated its antioxidant, anti-cancer, and anti-inflammatory qualities are contributed by its bioactive compounds, mainly phycocyanin. Other compounds or elements include phycocyanobilin, carotenoids, unsaturated fatty acids, selenium, and amino acids. Breast cancer is one of the major causes of cancer related death in women. As some of the cancer therapies are highly associated with side effects, nutraceuticals such as Spirulina could be an alternative therapeutic intervention. Although some research has been conducted to investigate the anti-breast cancer effects of Spirulina in the past, its mechanism of action is not entirely understood. Previous studies suggest that it may trigger apoptosis and autophagy via modifying signalling pathways such as NF-κB and Bcl-2/Bax ratio. It also has anti-proliferative properties, inhibits cell migration, causes cell cycle arrest, and lowers cancer cells' capacity to form colonies. Phycocyanin has been shown to produce reactive oxygen species (ROS) and down-regulate anti-apoptotic molecules, which contribute to its anticancer capabilities. These findings show that Spirulina fights cancer by targeting a variety of cellular mechanisms involved in carcinogenesis. While these data imply potential benefits, more clinical trials and research into the exact mechanisms of Spirulina in cancer treatments are needed to fully demonstrate its efficacy in treating breast cancer in humans.

INTRODUCTION: In the clinical setting, erectile dysfunction (ED) is a significant issue that should not be neglected, as it can adversely impact the quality of life of patients and their partners, especially among overweight and obese populations. This study aims to determine the prevalence of ED and its associated factors among non-diabetic, overweight, and obese patients who attend a government health clinic in Kuantan, Pahang, Malaysia. MATERIALS AND METHODS: A six-month cross-sectional study was conducted from February 2024 to August 2024 at twelve health clinics in Kuantan, Pahang. The selected respondents were married men over 18 years old, and those with diabetes mellitus, cardiovascular disease, psychiatric illness, or illiteracy were excluded. Data were collected using the validated Malay version of the International Index of Erectile Function (IIEF-5). ED was defined as an IIEF-5 score of less than 22. Descriptive analysis and simple and multiple logistic regression were performed using SPSS. RESULTS: All 221 eligible patients in the study responded (100% response rate). The prevalence of ED was 66.1% (n=146). Multiple logistic regression showed that ED was significantly associated with dyslipidemia [AOR (95% CI): 2.42 (1.06–5.52); p-value=0.036], anxiety [AOR (95% CI): 3.99 (1.44–11.01); p-value=0.008] and older age [AOR (95% CI): 1.07 (1.02–1.12); p-value=0.009]. CONCLUSION: The study revealed a high prevalence of ED among non-diabetic overweight and obese patients, potentially linked to increasing age, dyslipidemia, and anxiety. Increasing awareness among the public and healthcare providers could improve detection rates in primary care.

INTRODUCTION: Mother-to-child-transmission of HIV, syphilis and hepatitis B is a significant public health issue in Indonesia. Triple elimination screening, which tests these three infections, is a crucial strategy for early detection and prevention, ideally conducted during the first antenatal visit (K1). However, the coverage of this screening remains suboptimal in several regions, including the Harapan Baru Health Center. This study aimed to test factors affecting participation in the triple elimination screening during the first antenatal visit among pregnant women in the service area of the Harapan Baru Health Center. MATERIALS AND METHODS: A cross-sectional study was conducted involving 50 pregnant women who attended their K1 visit in June 2025. Participants were selected using convenience sampling. Data were gathered through structured questionnaires and maternal and child health (MCH) books and analysed using the Pearson chi-square test. RESULTS: Respondents’ knowledge (OR=5.4, p=0.023) and health worker support (OR=10.7, p=0.002;) were significantly associated with screening participation. However, the education level was not significantly associated. CONCLUSION: Good knowledge level and positive support from health workers could increase the likelihood of pregnant women undergoing triple elimination screening during their first antenatal visit.

INTRODUCTION: Glaucoma is a leading cause of permanent blindness, often going undetected in its early, asymptomatic stages, especially in older age groups. In Malaysia, glaucoma is a growing public health issue due to an increase in the ageing population. While screening is essential for early glaucoma detection, the most suitable strategy for Malaysia's healthcare system remains unclear. This study explored the perspectives of eye healthcare professionals on the most suitable glaucoma screening strategies for Malaysia. MATERIAL AND METHODS: This qualitative study used semi-structured interviews with 19 eye health professionals (ophthalmologists, optometrists, nurses, ophthalmic technicians, and assistant medical officers) practicing in the Klang Valley. The interviews were conducted face-to-face in their workplace or via a video conferencing platform. All interviews were recorded, transcribed, and analysed using thematic analysis. RESULTS: Six major themes were identified: types of glaucoma screening programmes, accessible screening locations, target screening population, instruments and use of digital technology, trained personnel, and referral criteria. Opportunistic case finding and population-based programmes were identified as the glaucoma screening programmes in which trained personnel conducted screening at accessible locations. Glaucoma screening for high-risk individuals was recommended, focusing on visual acuity testing, tonometry, anterior chamber angle assessment, funduscopy, perimetry, and retinal nerve fibre assessment. A lack of clear referral criteria due to low awareness and poor implementation of existing guidelines was observed. CONCLUSION: Further investigations are required to identify the best combination of components for glaucoma screening. This will enable policymakers to develop an effective glaucoma screening programme in Malaysia.

The present systematic review explores the most sexually dimorphic parameters by using geometric morphometric analysis of human skull. An extended search was conducted in Google Scholars and PubMed (published between 2005 and 2017). The main inclusion criteria were research articles published in English, and studies that used geometric morphometric analysis for classification of human skull. The literature search identified 54 potential relevant articles whereby, five had met the inclusion criteria. Most studies reported positive contribution of geometric morphometric as an alternative and accurate tool for classification of unknown human crania. Geometric morphometric method resulted in a high classification accuracy of sexual dimorphism among different populations. Further studies are required to approach the best method used for varied types of postcranial bones equipped with a more advanced meta-analysis of the results.

INTRODUCTION: Subclinical changes that occur in the heart at an early age may provide valuable information to outline prevention strategies for cardiovascular diseases. Heart rate variability (HRV) reflects regulation of autonomic balance, heart, and vascular tone, which are the determinants of blood pressure. Therefore, this study aimed to determine the difference in heart rate variability (HRV) of Malay male young adult with their BMI and adiposity level. MATERIALS AND METHODS: A total of 201 Malay male young adult aged between 19 to 24 years old were screened and their BMI and adiposity level were measured. Three non -invasive tests; Valsalva Manoeuvre, orthostatic response and 30/15 ratio of heart rate were performed. Short term HRV time and frequency domains were recorded. RESULTS: Despite few significant differences in HRV parameters of overweight/obese subjects, the result is inconclusive to conclude any reduced variability. However, those with high adiposity regardless of their BMI reported significantly lower mean of R -R SD in time domain and lower mean of LF/HF ratio in frequency domain. The orthostatic reflex results revealed that high adiposity subjects had significantly lower mean of LF and HF. A decrement of -0.28 ms2 HF/LF during Valsalva manoeuvre, -0.35 LF ms2 in orthostatic reflex and 0.33 ms2 in orthostatic reflex per 1% of body fat percentage were observed. CONCLUSION: HRV parameters were inversely proportional to the adiposity level which was suggestive of modulation of sympathetic function can occur at an early age.

Introduction: Currently, there is a lack of clinically feasible and reliable method for discriminating outcome in sepsis. We aimed to derive a new bioscore for predicting mortality in critically ill patients with sepsis using a combination of biomarkers and clinical indexes. Materials and Methods: This was a secondary analysis from a prospective study involving 159 patients with sepsis admitted to an intensive care unit (ICU). Data for key variables considered for possible inclusion in the score were collected, which included: age, sex, source of admission, comorbidities, microorganism, bacteraemia, site of infection, septic shock status, baseline Simplified Acute Physiological Score II, Sequential Organ Failure Assessment (SOFA) score (total and organ sub-scores), C-reactive protein, procalcitonin and interleukin-6 (IL-6). Approximate quintiles of each variable were given points as per the strength of their association with 30-day mortality. Results: In accordance with the statistical significance in the logistic regression analysis, the final score utilised candidate variables of age, central nervous system and liver SOFA sub-scores and IL-6. The bioscore predicted 30-day mortality with a very good performance [area under the receiver operating characteristic curve 0.814 (95% confidence interval 0.745-0.871, p <0.0001)] in our sepsis cohort. A bioscore greater than 4 predicted 30-day mortality with 80.4% sensitivity, 69.9% specificity, 2.67 positive likelihood ratio and 0.28 negative likelihood ratio. As the score increased, so did mortality rate. Conclusion: A new bioscore combining age, central nervous system and liver SOFA sub-scores and IL-6 measured on ICU admission potentially improves prediction of mortality in sepsis. Further study is warranted to prospectively validate the clinical utility of this bioscore in risk-stratifying patients with suspected sepsis.

Introduction: Flood disaster is a natural disaster that has unexpectedly occurred again. Community cooperation in terms of managing flood and focusing on families’ needs has become more systematic. It is important for a household to be prepared in any disaster. One of the preparations that should be done is the stockpiling of emergency supplies or flood supply kits during evacuation. This study aimed to develop a specific disaster kit for households for evacuation during a flood disaster based on cultural context. Methods: Data were collected from 75 key informants from every level of households that really have a great experience during the flood disaster that helping family packing for a living needs before evacuation. The development of the disaster kit based on cultural needs and all their views, needs, experiences, challenges, frustration and happiness was obtained from the interview sessions. Results: There are five themes that emerged from this research related to developing a disaster kit. The themes are community preparedness in dealing with flood disaster, hygiene issues during the flood, inadequate food supply, how the community responds to insufficient water supply, and coping method with illness. After being finalized, there are seven kits: a general supplies kit, documentation kit, emergency food and water supply kit, prayer kit, hygiene kit, basic first aid kit, and baby kit. Conclusion: The development disaster kit was created to help the communities to be more aware and prepared before disaster strikes.