Auricular perichondritis is an uncommon but potentially serious complication of ear piercing, particularly when the cartilaginous part of the auricle is involved. It is most often caused by bacterial infection, with Pseudomonas aeruginosa being the predominant pathogen, and may lead to cartilage necrosis and permanent deformity if not promptly treated. We report the case of a patient who developed auricular perichondritis following ear piercing, presenting with painful swelling, erythema, and tenderness of the pinna while sparing the lobule. Clinical diagnosis was supported by physical examination, and management consisted of early systemic antibiotic therapy combined with local care, leading to a favorable outcome. This case highlights the importance of early recognition of auricular perichondritis, appropriate antimicrobial treatment, and awareness of piercing-related risks to prevent functional and cosmetic sequelae.

Introduction: Polyherbal extracts contain various bioactive compounds that work synergistically to provide stronger therapeutic effects than single extracts. However, their use in the pharmaceutical field still faces challenges, especially related to low solubility, instability, and limited bioavailability. Microparticulate system technology presents an innovative solution that can increase the effectiveness of herbal drug delivery through physical protection of active compounds, controlled release, and increased absorption in the body. Objective: This review discusses research progress that integrates polyherbal extracts in microparticulate formulations, including polymer selection, manufacturing techniques, characterization, and pharmacological evaluation. Methods: A systematic literature review was conducted through searches in the last ten years [2015–2025] obtained through databases such as PubMed, ScienceDirect, and Google Scholar using keywords related to "polyherbal" and "microencapsulation" with a focus on articles on formulation studies and pharmacological evaluations in the last ten years. Results: The study showed that microparticulates were able to improve the entrapment efficiency, phytochemical stability, and therapeutic activity of polyherbal extracts, especially in oral and transdermal routes of administration. However several limitations such as the variability of natural product composition, potential interactions between compounds, and regulatory challenges still require further attention. The development of more advanced formulation technology as well as standardized toxicological and clinical studies are urgently needed to encourage the implementation of microparticulate herbal products on an industrial scale. Conclusion: Overall, polyherbal microparticulate systems have promising prospects as a safe, effective, and competitive strategy for modernizing herbal medicines.

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.

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.

Background: Early and accurate diagnosis of dengue fever (DF) is indispensable for patient management and outbreak control in endemic areas such as Bangladesh. S ns1 as an early diagnostic marker is a challenge, and there are many formats of “rapid test” (RDT) today, the sensitivity and specificity of all RDT in relation to molecular gold standard has yet not been well defined for use among more vulnerable population with highest dengue burden. The objective of this study was to assess the diagnostic performance of a commercial NS1 RDT and an NS1 ELISA with reference to real-time reverse transcription-polymerase chain reaction (RT-PCR) for early dengue diagnosis. Methods: A prospective diagnostic accuracy study was conducted from July 2024 to June 2025 at two tertiary hospitals in Dhaka. We enrolled 200 consecutive patients with acute febrile illness (≤5 days) meeting the WHO suspected dengue case definition. Serum was simultaneously tested with the SD BIOLINE Dengue Duo NS1 rapid diagnostic test (RDT), the PANBIO™ Dengue Early enzyme linked immunosorbent assay (ELISA) and a multiplex real time reverse transcriptase PCR. Sensitivity, specificity, predictive values and concordance (Cohen’s kappa) were estimated with 95% confidence intervals (CI). Performance was analyzed by day of illness and association with RT-PCR cycle threshold (Ct) values. Results: Out of the total 200 patients, confirmed RICT dengue-positive was found in 124 (62.0%) by RT-PCR. The NS1 ELISA was significantly more sensitive compared with the RDT (91.9% [85.6-96.1] versus 74.2% [65.5-81.6]; p<0.001). Specificities were 96.1% (88.9-99.2) with ELISA and 92.1% (83.6-97.0) with RDT. ELISA testing had good concordance with RT-PCR (κ=0.87), whereas the RDT administered only a moderate concordance (κ=0.66). Sensitivity of both tests waned with delay in presentation, but this was more marked for the RDT which registered a sensitivity of 59.1% by day 4-5. The most influential factor for both tests false negative was high RT-PCR Ct values (low viral load). Conclusion: The NS1 ELISA is far superior to the NS 1 RDT for early diagnosis of dengue in Bangladesh hospital. Though the RDT serves as a rapid triage tool, it comes with a high false-negative rate after the early febrile stage, and should be used cautiously. A reflex testing algorithm with RDT as initial screening, followed by ELISA confirmation of negative RDT cases, should be considered in order to maximize early case detection and patient management.