Background: In dengue-endemic countries such as Bangladesh, early discrimination of dengue from other acute febrile illnesses (AFI) in outpatient practice is a pivotal practical strategy to expedite proper case management and optimize resource utilization, but the predictive value of common symptoms like myalgia and chills are poorly quantified. The prevalence, diagnostic accuracy and independent predictors for laboratory confirmed dengue among adults’ outpatients in Dhaka, Bangladesh were the objectives of this study. Methods: A hospital-based cross-sectional study was carried out in two tertiary hospitals, Dhaka during the period from January to December 2025. The consecutive AFI (History & examination duration ≤7 days) adults older than 18 years were included. Symptoms were assessed using a structured questionnaire and included information on myalgia (presence and severity, from 1 to 10), and chills. NS1 antigen and/or IgM antibody using a WHO-prequalified rapid test (SD BIOLINE Dengue Duo) were used to confirm dengue illness. Summary (max 100 words): Diagnostic accuracy was determined, and independent predictors were identified using multivariate logistic regression. Results: Dengue prevalence was 42.2% (76/180) in a total of 180 studied individuals. Myalgia was reported in 93.4% vs 68.3% in dengue-positive than dengue-negative patients (p<0.001) revealing a high sensitivity (93.4%) but low specificity It was the prevalent symptom/sign among both cases and controls (Table 2A). Myalgia (≥5 score) had a specificity 55.8%. Chills were less predominantly observed among dengue-positive patients (44.7% vs 71.2%, p<0.001) and had moderate specificity 71.2%. In multivariate analysis, myalgia was a strong independent predictor (aOR=5.87, 95% CI: 1.99–17.29), while chills were inversely associated with dengue (aOR=0.41, 95% CI: 0.21–0.80). Conclusions: Severe myalgia is a sensitive clinical marker, whereas chills should raise the possibility of other causes. Targeting such symptom presentations can help contribute to early clinical suspicion and prioritize testing in the outpatient settings affected by dengue epidemics.

Medical humanities, an interdisciplinary field, analyzes illness narratives to study the representation of disease, medicine and medical professionals. Among the illness memoirs, the patient as well as the doctor narratives became popular, as majority of the readers experienced a therapeutic relief of their hidden fears related with disease and death. The victory of modern medicine, challenges faced by the medical professionals and the doctor-patient relationship are the main themes of medical memoirs. The present study focuses on the doctor memoirs and it tries to study how far bioethical concepts have influenced the depiction of medical experience by doctors.

Sweet pepper (Capsicum annuum L.) production is seriously restricted by anthracnose disease caused by Colletotrichum spp., leading to significant yield losses globally. Dependence on synthetic fungicides has raised serious concerns over fungal resistance, environmental contamination, and human health risks, necessitating ecofriendly alternatives. This study investigated the antifungal potential of aqueous extracts from neem (Azadirachta indica) seeds and onion (Allium cepa L.) bulbs against anthracnose in sweet pepper under controlled pot conditions. The design employed weekly foliar applications of 200 ml/m² neem seed extract, onion bulb extract, or untreated control on anthracnose-inoculated plants. Parameters assessed were leaf number, plant height, fruit yield, disease severity and agronomic efficiency index. Both extracts significantly improved vegetative growth, increased fruit yield, and reduced disease incidence compared to the control. Neem seed extract exhibited slightly better performance in promoting leaf retention and plant height. Strong positive correlations were observed between growth traits and yield, while disease severity showed significant negative correlations with productivity. The findings reveal that neem seed and onion bulb extracts effectively suppress anthracnose, improve plant performance, and offer promising eco-friendly alternatives to synthetic fungicides for sustainable sweet pepper cultivation.

Background: In many urban and peri-urban settings, access to safe drinking water continues to be a major public health issue. Although infrastructure has improved, the association of multidimensional household water access and clinical gastrointestinal (GI) morbidity is incompletely described for hospital-based populations. We sought to examine the relationships of household drinking water access across dimensions with GI morbidity among patients and their caregivers in tertiary hospitals in Dhaka, Bangladesh. Methods: A hospital-based, analytical cross-sectional observational study was carried out from July to December 2025 in two tertiary-care centers. The sample of 150 patients were recruited by consecutive sampling. Data was obtained through face-to-face interviews with a structured questionnaire which included collection of socio-demographics, methods of access to household water (source, treatment, availability and perceived quality), GI morbidity in the past six months. Independent predictors of GI morbidity were determined by multivariable logistic regression. Results: The prevalence of household GI morbidity was 72.0%. Strong bivariate predictors of GI illness included, unimproved water source (90.5% vs. 58.6% for improved sources, p<0.001), no water treatment (94.4% vs. 59.4% for treated water, p<0.001), access <12 hours/day (78.3% vs 66.7%, p=0.035) and belief that there are problems with perceived quality of drinking water (85.3 % VS.43.8 %, P< 0.001). In multivariate analysis, not practicing household water treatment was the most significant independent risk factor (aOR=8.45; 95% CI: 2.68-26.68). Additional strong predictors were perceived water quality problems (aOR=6.03), use of unimproved water sources (aOR=2.91) and access <12 hours/day (aOR=1.72). Conclusion: This study exhibits a robust, independent relationship between unimproved household water access, and in particular lack of point-of-use treatment with GI morbidity. The results point to a dual approach for public health: widespread household water treatment should be promoted as an immediate measure; and also, parallel investment in reliable, higher-level source improved infrastructure that can address the burden of waterborne disease in other such urban settings.

Physician training provides a critical lens for examining the structural strengths, limitations, and ethical orientations of healthcare systems. This commentary reflects on internal medicine training within tertiary settings in Doha [Qatar] and Ottawa [Canada] analyzing how organizational design and sociocultural context influence continuity of care, supervisory accessibility, documentation practices, evidence integration, and equity. Drawing on first-hand clinical engagement, the discussion moves beyond descriptive comparison to interrogate institutional responsibilities toward trainees, particularly the proportionality of educational benefit relative to the financial, emotional, and logistical burdens of international training pathways. By centering trainee narratives, this work underscores experiential insight as foundational to meaningful health system reform. How physicians are trained ultimately shapes clinical competence, ethical integrity, and the humanism of care delivery.

Introduction: Childhood disability represents a significant public health challenge in low-resource settings, yet detailed epidemiological profiles of children attending special education institutes in Bangladesh remain scarce. This study aimed to identify the pattern of disabilities and associated socio-demographic, perinatal, and familial characteristics among differently abled children attending Islami Bank Medical College and Hospital in Rajshahi, Bangladesh. Methods: A cross-sectional study was conducted among 120 children attending Islami Bank Medical College and Hospital in Rajshahi, Bangladesh. Data were collected via face-to-face interviews with mothers or guardians using a pre-tested, partially structured questionnaire. Disability types, birth history, maternal health, and familial factors were analyzed using descriptive statistics and chi-square tests in SPSS version 22. Result: The mean age of children was 8.85 (±4.25) years; 66.7% were male. Autism spectrum disorder was the most common disability (44.2%), followed by cerebral palsy (15.8%), Down syndrome (15.0%), and multiple disorders (13.3%). Half (50.8%) exhibited multiple co-occurring disability characteristics. Significant associations were found between disability type and sex (p<0.05), prematurity/low birth weight (p<0.001), birth trauma (p<0.001), and maternal age at conception (p<0.001). Despite 90.8% antenatal care coverage, 92.5% of mothers did not take folic acid during the first trimester, and 95.0% were unaware of micronutrient deficiencies. Conclusion: Autism is the predominant disability among children in this setting, with notable links to perinatal factors and maternal age. Critical gaps persist in maternal nutrition awareness and perinatal care. Findings underscore the need for targeted autism services, strengthened perinatal interventions, and integrated maternal health education to mitigate disability risks and improve outcomes for differently abled children in Bangladesh.

Precision nutrition is a potentially disruptive paradigm of nutritional science that seeks to precisely customize food advice depending on the biological, genetic, environmental, and lifestyle factors of individuals. The intensive research growth in human and animal nutrition, nutrigenomics, metabolomics and data-driven methods has produced a convoluted and multidisciplinary literature that is difficult to synthesize in terms of conventional narrative methods. The current paper presents a combined bibliometric and scientmetric review of the world-wide research on precision nutrition published in PubMed index between 2005 and 2025 which incorporates the performance analysis, science mapping and multivariate conceptual approaches. One hundred and thirty-two publications were analyzed in 81 sources with the help of Bibliometrix R package and VOSviewer. Temporal analysis indicated that the output of research has increased significantly since 2015 as a result of increasing use of omics technologies, microbiome research, and computational analytics. The source analysis revealed that there is a high concentration of journal that has a few core nutrition journals that cover a huge percentage of the publications, which is in line with the law of Bradford. The geographic evaluation showed that the high-income nations, especially the United States and Western Europe, had been dominant, with a moderate yet growing cooperation at the international level. The keywords co-occurrence networks, density mapping, and overlay visualization revealed diet-health interaction, nutrigenomics, and human nutritional status as the key themes of research, whereas artificial intelligence and microbiome-based personalization and precision feeding in animals became emerging directions. Several correspondence analyses also showed the specific conceptual axes between molecular and omics-oriented research on the one hand and, on the other hand, applied and preventive nutrition areas. All the results point to parallel, but still not fully integrated processes of human and animal precision nutrition studies. The paper has provided a strategic overview of intellectual, thematic, and future directions of the field of precision nutrition, which offers a solid evidence base to guide interdisciplinary research, translational implementation, and policy formulation.

Hemangiomas are common tumors that exhibit microscopic blood vessel proliferation. Congenital hemangiomas frequently present from birth and may become increasingly noticeable over time. Their origin is most likely developmental rather than malignant. This report describes a 6-year-old girl's gingival hemangioma and the way a sclerosing agent was used to treat it. The aim of this case report is to demonstrate the therapeutic benefits of boiled saline as a sclerotherapy for oral hemangiomas. Boiled saline is a safe and effective sclerosing therapy for oral hemangiomas. This method provided our patient with significant symptom relief at a minimal cost with few complications.

This study seeks to determine the impact that Environmental Management Accounting (EMA) has on the corporate sustainability using current evidence and literature developed by the academic community. It is inspired by the fact that, while organizations have implemented environment- conscious strategies geared towards ensuring that corporates play their role as responsible citizens especially in the war against global warming and environmental degradation, statistics depict an alarming rise in the volume of emissions and poor performance in other key indicators. Considering that EMA is one of the contemporary strategies organizations use to track operational performance and support responsible decision-making, this research seeks to answer the following questions. i. Does EMA impact sustainability in organizations operating within the high-impact industries such as petrochemical sector, Oil and Gas industry, and manufacturing industries? ii. What mechanisms does EMA use to influence the level of corporate sustainability in the organization? To answer the above questions, the research relied on secondary data documented in the existent literature. The results established a significant relationship between EMA and corporate sustainability and points to the fact that a myriad of external and organization-facing factors mediate this relationship.

Additive manufacturing (AM), also known as 3D printing, has emerged as a transformative technology across various manufacturing sectors. It enables the fabrication of complex geometries, high-volume customization, significant material savings through layer-by-layer manufacturing methods, and the potential for the use of Eco-friendly materials. This technology offers significant freedom in the design and fabrication of complex geometric parts, with the potential to reduce costs in both prototyping and final product manufacturing, as well as reduce waste through the recycling of materials lost during manufacturing processes. Although its adoption in the ceramics industry has lagged that of polymers and metals, its unique capabilities in fabricating complex geometries of high-performance ceramics are receiving significant attention. This review provides a comprehensive overview of the current landscape of AM technologies specifically designed for ceramic materials. It explores the underlying principles of various ceramic 3D printing processes, highlighting their advantages and disadvantages in producing high-density, defect-free components with customized properties. Furthermore, this paper examines the transformative impact of AM on ceramics in various structural and functional industrial applications, including aerospace, biomedicine, electronics, energy, and more. By bringing together the latest developments and addressing the inherent challenges associated with ceramic processing via additive manufacturing, this review highlights the tremendous potential of this technology to revolutionize conventional ceramic manufacturing and enable the production of advanced ceramic components with enhanced performance and functionality.

Immune-mediated inflammatory diseases (IMIDs) characterized by three nosological entities, autoimmune diseases, autoinflammatory diseases and inflammatory diseases of undetermined mechanism, share in common the inflammatory process but their clinical and biological expressions are extremely diverse. Epidemiological and clinical studies of IMIDs are mostly partial and non-exhaustive. Affections that constitute IMIDs are characterized by chronic inflammatory processes. All these affections are classified based on their immunogenetic, pathophysiological, and clinical profiles. It is well understood that similar therapeutic targets as well as prevention and treatment strategies can be developed for IMIDs with the same immunogenetic, pathophysiological, and clinical profiles. This work presents an immunogenetic, pathophysiological, and clinical classification, now especially integrating epidemiological data (rare <1/2000; common ≥1/2000). To achieve this, a literature review was also necessary to refine the classification by adding the epidemiological data (rare <1/2000; common ≥ 1/2000). This work highlights the comprehensive distribution of IMIDs through an immunogenetic, pathophysiological, and clinico-epidemiological classification.

The Santals are an ethnic tribal group who mostly inhabit the states of Jharkhand, Bihar, West Bengal, Odisha, Chatisgarh, and Assam. There is also a sizable Santal minority in neighboring Bangladesh and a small population in Nepal. Santals constitute the largest group among tribal communities. They belong to the Proto-Australoid race. The settlement of Medinipur known as Santal was first mentioned in Walter Hamilton's narrative (1820). He said that in the jungles lived an impoverished, oppressed class known as Santals. Some believe the term 'Santal' originated from 'Saont' or 'Samanta'. Once, an area of East Medinipur was known as 'Samantabhum' or 'Saont'. Most likely, they were the original inhabitants of this region. They also mentioned this place 'Sant Disham' or 'Sant Desh' in their mythology. 'Santal' means inhabitant of 'Sant Desh'. The Santal tribe of India have a traditional tribal lifestyle. Forest trees and flora serve the basic needs of Santal tribe.The tribes are also engaged in fishing and cultivation. Theys are also skilled in the production of musical instruments, mats, baskets, and other crafts.The Santal tribe is divided mainly into twelve sects viz. Soren, Murmu, Mandi, Kisku, Hansda, Besra, Tudu, Baske, Hembrom, Pauria, Bedea and Choral. Each sect has a totem symbol of its own. The traditional marriage system in Santal tribe is a religious practice as a goddess of happiness and heaven. In this paper we see the different kinds of rituals which are practiced by the Santal tribe from hundred and thousand years in their marriage and remarriage.

Background: Surgical site infection (SSI) and wound complications continue to constitute one of the most significant causes of morbidity after pediatric cardiac surgery. New prevention methods, standard care bundles, and negative pressure wound therapy (NPWT) have been developed to enhance postoperative outcomes. Purpose: This systematic review article aims to determine evidence published over the past 10 years on wound management strategies after cardiac surgery in children, including their prevention, treatment, and outcomes. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science for studies published between January 2016 and March 2025. Articles that focused on wound prevention, surgical site infections, sternal wound care, or NPWT in children's cardiac surgery were incorporated. Results: Fifteen studies involving over 3,000 pediatric cardiac surgery patients were included. Implementation of standardized prevention bundles resulted in a 30–70% reduction in SSI rates, while NPWT achieved wound closure success exceeding 85% in cases of deep sternal wound infection and mediastinitis. Conclusion: Standardized cardiac pediatric wound management interventions based on prevention bundles and early administration of advanced wound therapies are most likely to be effective following pediatric cardiac surgery. The strategies play a crucial role in minimizing morbidity and enhancing recovery among pediatric patients.

This paper underscores the crucial role of heritage awareness in the ongoing struggle for liberation and social affirmation of African American communities. It critically examines the correlation between black cultural and spatial memory and the fight for social equality in Dolen Perkins-Valdez’s work Happy Land, illustrating how heritage awareness and preservation function as foundations for identity, resistance, and social dignity. Through the novel, it tries to make the case on how memory and heritage empower resistance and can empower the ongoing pursuit of equality for African Americans. The study also observes that dominant groups often shape historical narratives to their advantage, marginalizing minorities and depriving the latter of the benefits embedded in their own history. Thus, passing down black heritage through storytelling empowers marginalized African Americans communities to reclaim and preserve their ancestral legacy and assert their claim to collective ownership of the American land. Through a psychoanalytic lens, the study explores how the affirmation of heritage not only fosters a sense of belonging and entitlement but also restores dignity to African Americans.

Background: Exam-related stress and anxiety are common occurrences among medical students, especially with changing curricular trends and assessment patterns. It leads to psychosomatic disturbances (Gastrointestinal disturbances, chronic pain disorders, substance abuse, drug overuse, depression, etc.) especially around exam periods. It lowers their academic performance and satisfaction levels, ultimately affecting the health care delivery in long run. Methodology: A pre-validated questionnaire was circulated among the exam-going students. Anonymous responses were solicitated to encourage honest responses. We used MS-Excel for quantitative analysis. Content and thematic analysis was done for qualitative responses. Results: Out of 205 responders, there were 88 and 117 students from 3rd and 4th MBBS year respectively. About 56% of students perceived moderate-to-significant exam-related stress. Apart from exams in general, most were apprehensive about practical exam performance and faculty expectations. Only about 42% were satisfied with their level/efforts of study against the academic workload. Common themes for causation were time management, concentration challenges, lack of guidance/support, and ineffective study techniques. Vast majority had sleep disturbances and about 60% had somatic disturbances. Students had a strong preference for informal and emotion-based coping. Conclusion: Exam-related stress in multifactorial and needs to be addressed appropriately. Implementing structured study schedules and time management techniques could alleviate some of the stress. Encouraging active learning methods, such as spaced repetition and active recall, might enhance retention.