The Zika virus, an RNA arbovirus, is known to trigger Guillain-Barré syndrome (GBS). However, to establish that the Zika virus is indeed the causative agent, its presence must be confirmed - preferably via direct PCR. Detection of anti-Zika IgM antibodies should not be used for this purpose, as they can persist. Confirming Zika as the trigger for GBS also requires ruling out all other potential causes of the syndrome. Furthermore, all comorbidities and concomitant medications must be documented and included in the analysis. Finally, it is essential to refer GBS patients, regardless of the underlying cause, to a specialized department as soon as typical clinical symptoms appear.

Hepatitis E virus infection is endemic in Nepal and commonly presents as an acute self-limiting hepatitis. Cardiac involvement is extremely rare and may be life-threatening. We report a case of a young female who presented with fever, jaundice, progressive dyspnea and hypotension. Laboratory assessment confirmed acute hepatitis E infection. Chest radiography revealed cardiomegaly with bilateral pulmonary infiltrates. Transthoracic echocardiography demonstrated left ventricular dysfunction. Other infectious causes of myocarditis were excluded. The patient improved with inotropic support, heart failure treatment and other supportive management, with complete clinical recovery on follow-up. This case highlights the importance of early cardiac evaluation in patients with acute hepatitis E with features of heart failure.

Actinomycetoma is a chronic, destructive infection of the skin and subcutaneous tissues that is often treated empirically in endemic settings because species identification and antimicrobial susceptibility testing are unavailable or delayed. We developed an Evidence-Concordance Framework (ECF) integrating published clinical outcomes, phenotypic susceptibility data and CARD-RGI resistome predictions for major Nocardia, Actinomadura and Streptomyces pathogens. Amikacin and linezolid showed the strongest concordance across the three evidence domains. Trimethoprim-sulfamethoxazole (TMP-SMX) remained the therapeutic backbone despite variable in vitro susceptibility, particularly among Streptomyces. Genomic resistance determinants often showed limited agreement with phenotypic or clinical outcomes. The ECF therefore supports TMP-SMX-based therapy, with amikacin and linezolid as strongly supported adjunctive or alternative agents. Genomic prediction should complement, not replace, clinical judgement, species identification and phenotypic susceptibility testing.

Global Health has accumulated unprecedented knowledge through frameworks, indicators, guidelines, datasets and increasingly powerful digital tools. Yet one valuable resource remains remarkably underused: the lived-in experience of people who have spent decades delivering grassroots health care. This experience is more than accumulated information; it is tacit wisdom shaped by repeated encounters with patients, communities, health systems, scarcity, failure, adaptation and unintended consequences. Such wisdom reveals what actually works, what fails, why programmes succeed or falter at the last mile, and where globally developed guidance requires local adaptation. As experienced health workers retire, this unwritten knowledge risks disappearing. Listening to them is therefore both a practical necessity and a form of respect.

Artificial intelligence (AI) chatbots are increasingly explored as clinical decision support tools, but their accuracy and applicability remain insufficiently evaluated. We therefore evaluated and compared the accuracy, completeness, readability, and real-world applicability of four AI chatbots in generating treatment plans for Paediatric Pulmonology Intensive care and Emergency cases.

We report a rare case of disseminated cryptococcosis gattii infection with initial central nervous system manifestations in a 28-year old male under regular treatment for systemic lupus erythematosus since 2020. He presented with headache evolving into hearing loss, hypogeusia, amblyopia and mental confusion. This case highlights the challenge of diagnosing opportunistic fungal infections in patients with chronic immuno-suppression, emphasizing how early targeted management is critical to mitigate severe neurological sequelae and reduce mortality.

Acute mesenteric ischaemia is a life-threatening emergency that is easily overlooked when several body systems are injured at once. We describe a 51-year old woman extricated 50 h after the earthquake of 6 February 2023 in Kahramanmaraş, Turkey, who presented with crush syndrome, oliguric acute kidney injury and peritoneal signs; her abdominal pain had begun while she was still trapped. Prolonged immobility and hypovolaemia during entrapment may produce in situ mesenteric thrombosis, and the abdomen of a crush victim warrants repeated examination.

Adult-onset IgA vasculitis is a rare, under-recognised cause of crescentic nephritis in adults, with infections, drugs and malignancies among common triggers; tuberculosis is also an uncommon but important one. We describe such a case.

Envenomation by venomous animals remains a critical public health issue in tropical regions; however, long-term global epidemiological trends have not yet been sufficiently characterised. By analysing data from the Global Burden of Disease study from 1990 to 2021, we found a decline in envenomation incidence and mortality globally, with South Asia being the region with the highest burden, despite recording the sharpest reductions. Disparities persist between working-age men and the elderly, highlighting the need for targeted occupational protection measures and improvements in antivenom distribution for emergencies.

Congenital syphilis (CS) is a significant infectious condition associated with a high social and economic burden. In the Americas, the epidemiological situation remains concerning, with varying patterns across countries. Our study evaluated temporal trends in CS incidence per 1000 live births in countries across the Americas between 2009 and 2021. An ecological study was conducted using data from the Pan American Health Organization and analyzed via the Joinpoint Regression Program and Project R. Sixteen countries were included, showing an average annual increase of 6.42% in CS incidence. Canada showed a continuous downward trend, while Cuba and Panama showed little change. Brazil, Paraguay, and Panama recorded the highest average incidence rates, while the other countries displayed heterogeneous temporal patterns, with periods of increase, decrease, and stabilization. These results highlight significant epidemiological inequalities and underline the need for targeted strategies for CS prevention, surveillance, and control in the Americas.