Background- Recurrent aphthous stomatitis (RAS) is a very common condition characterized by recurrent painful oral ulcers, which significantly affect the quality of life in affected patients. Despite its high prevalence, the etiology and optimal management of RAS remain elusive. A variety of therapeutic interventions, from topical and systemic treatments to newer approaches such as laser therapy, probiotics, and plant-based therapies, have been pursued. Objective: This systematic review aims to analyze the published evidence on the diagnosis and treatment of RAS, in terms of discovering effective interventions and gaps in the literature. Methods- RCTs on diagnosis or treatment of RAS were included. A systematic search was conducted across six databases: PubMed, Scopus, Embase, Web of Science, Cochrane Library, and CINAHL, employing Boolean operators and MeSH terms. Data were independently extracted by two reviewers; these included study characteristics, population demographics, interventions, outcomes, and statistical methods. The risk of bias was assessed employing the Cochrane Risk of Bias 2.0 tool. Results- A total of ten RCTs was included, ranging between diverse interventions such as probiotics, laser therapy, systemic drugs, and plant-based therapies. Commonly analyzed main outcomes included pain reduction as well as ulcer size, while some studies of healing time, recurrence rates, and complete remission took place. Pain and ulcer size reduced the most significantly in laser therapy, probiotics, and topical agents like zinc sulfate and caffeic acid. Vitamin B12 significantly decreased recurrence rates and reached a high ulcer-free status. Multivitamin supplementation was devoid of significant effects. The vast majority of studies reported no adverse events; however, systemic drugs such as thalidomide and dapsone were accompanied by well-known toxicities. Statistically, the methods utilized were Mann-Whitney U, Friedman tests, and advanced models such as ANCOVA in order to strengthen the analysis. Conclusion- This review demonstrated that advanced treatments, including laser therapy, probiotics, and natural compounds, are effective for the treatment of RAS, so promising alternatives emerge for currently used methods. Systemic drugs still prevail in extreme cases but are limited by side effects. The results highlight the imperatives of personalized therapeutic strategies and high-quality research to promote optimization in the management of RAS

According to WHO, 16% to 40% of children aged 6 to 12 suffer a dental trauma.1This means that almost half of all children are likely to suffer a traumatism involving one or more teeth, during daily activities like playing and sports. In this age group, children have a mixed dentition, with both deciduous and permanent teeth. However, the chronology of permanent teeth eruption places the permanent maxillary central and lateral incisors in the beginning of this time period, around the age of 8.2 This fact, corroborated with their placement in the most anterior position, make them the permanent teeth most likely to be affected in a traumatism involving the oral region.

Introduction C. neoformansis a major cause of disease in immunocompromised hosts, especially people living with HIV/AIDS. In the last decade, there have been increasing reports of cryptococcal disease in immune competent patients, for whom no definitive diagnostic algorithm, therapeutic options and prognostic data are available. Methods This is a retrospective study conducted at a tertiary care hospital over a period of 6 years, analysing and comparing the clinical presentation, risk factors, laboratory findings, evolution, outcomes and prognosis of confirmed cases of cryptococcal disease in immunocompromised and immune competent patients. Results During the study period, a total of 20 patients with cryptococcal disease were identified (8 immune competent and 12 immunocompromised). The median time to diagnosis was much longer in immune competent patients compared to immunocompromised patients, 90 (15-110) days and 20 (7-75) days respectively (p=0.019). CSF findings were similar between the 2 groups except that mean CSF protein levels were significantly lower (78.5±15.1 mg/dL) in immune competent patients compared to immunocompromised patients (181.9±150.9 mg/dL) (p=0.036). Serum cryptococcal antigen was positive in all patients. A total of 83.3% patients in the immune competent group and all patients in the immunocompromised group had satisfactory outcome at the time of discharge and follow up over a period of 12 months. Conclusion Cryptococcal disease is not uncommon in immune competent hosts and diagnosis is usually delayed because of a low index of clinical suspicion. Serum cryptococcal antigen could serve as a valuable screening test. Despite the fact that we found no significant differences in terms of outcome between the two groups (p=0.400), the median time to diagnosis was much longer in the immune competent group compared to the immune compromised group, which emphasizes the need for clinical awareness of this entity in immune competent patients.

Introduction The prevalence of malnutrition or undernutrition in hospitalized adults is estimated to be around 31.4% in the USA and European countries. Patients who require hospitalization for infectious diseases make up a particular type of patient population, at risk for malnutrition either due to the catabolic processes, generalized inflammation and higher nutrient demand associated with infection, or to the direct action of the infectious agent itself, such as in infectious diarrhea, malabsorption and external losses. MethodsWe performed a cross-sectional study to screen for the risk of malnutrition in the first 24 hours following hospital admission in a population of adult patients admitted to a national reference center for infectious diseases in Bucharest, Romania, using the Malnutrition Universal Screening Tool (MUST) and a standardized medical questionnaire. ResultsThe study included 211 patients with a median (interquartile range – IQR) age of 52 (33-68) years, and a male-to-female ratio of 1:1.7. The median (IQR) duration of hospitalization was 6 (4-10) days, and the median (IQR) number of drug classes required during hospitalization, 2 (0, 3). The number of previous hospitalizations during the past 12 months ranged from 0 (24.2%) to 5 (1.9%), most patients (42.7%) presenting one recent previous hospital admission. Overall, 22.7% of those included in the study presented a risk of malnutrition (5.7% medium risk and 17% high risk). Malnutrition was most common (50%) in patients admitted for viral upper respiratory tract infections, followed by HIV infection and meningitis (33.3% each). The MUST score was directly dependent on patient age (p=0.030), number of previous hospitalizations during the past 12 months (p=0.002), number of drug classes required for treatment (p=0.034), and duration of the current hospital admission (p=0.029), a high risk of malnutrition associating a 1.4 days increase in the mean length of hospital stay (p=0.041) in our patient group. Conclusion In conclusion, we have reported the overall malnutrition risk in Romanian patients hospitalized for infectious diseases, while identifying the main patient categories and types of infections that associate higher malnutrition risk, findings which can substantiate future national screening policies.

Introduction Subsequent to the devastating flood in Chennai, South India, in November and December 2015, an increase in the number of cases of melioidosis was noted. Case series We performed a retrospective chart review of patients with melioidosis to analyze the clinical profile and the association with flood water exposure. All patients with blood or any other sterile site specimen growing Burkholderia pseudomallei between 9 November 2015 and 8 January 2016 were studied. Twelve patients with blood culture growing B. pseudomallei were identified during this two-month period. All were from the flood affected area and 11 had definite flood water exposure, and the majority had diabetes as comorbidity. The time period from exposure to onset of symptoms ranged between 5 to 24 days. All patients presented with fever, 3 had pneumonia and 8 had septic foci elsewhere. All had bacteremia, 4 had one other culture positive site. Overall, 33% mortality was noted. Conclusion Following the flooding season there was an increase in melioidosis cases with a definite association with flood exposure. Understanding the epidemiology, rainfall and flood exposure as risk factors is important for early identification of these cases.

In our quest for eliminating specific viral infections, different tools serve different purposes, as elimination is a multifactorial process, its very definition stating that it is a result of deliberate efforts, and that is requires continued intervention.