Background: Melasma, a chronic hyperpigmentation disorder, is frequently observed in women during pregnancy and the postpartum period due to hormonal influences. This study aimed to compare the efficacy of topical and systemic therapies in treating melasma among pregnant and postpartum women. Methods: A prospective comparative study was conducted on 60 women, including 30 pregnant and 30 postpartum patients diagnosed clinically with melasma. Pregnant women received only topical therapy (combination of hydroquinone 2%, azelaic acid, and broad-spectrum sunscreen), while postpartum women were randomized into two groups: one receiving topical therapy (n = 15), and the other receiving systemic therapy (oral tranexamic acid 250 mg twice daily) along with sunscreen (n = 15). The Melasma Area and Severity Index (MASI) was recorded at baseline, 8 weeks, and 16 weeks. Results: In the pregnant group (n = 30), topical therapy led to a mean reduction in MASI score from 12.8 ± 2.3 to 8.4 ± 1.9 after 16 weeks (34.4% reduction, p < 0.01). In the postpartum group, patients on systemic therapy (n = 15) showed a more significant improvement in MASI scores, from 13.2 ± 2.1 to 6.5 ± 1.6 (50.8% reduction, p < 0.001), compared to those on topical therapy (n = 15), who improved from 13.0 ± 2.0 to 9.0 ± 1.8 (30.8% reduction, p < 0.05). Mild adverse effects, such as transient skin irritation, were reported in 4 patients on topical therapy; no systemic side effects were observed. Conclusion: Topical therapy is effective and safe during pregnancy for managing melasma. However, systemic therapy with oral tranexamic acid in postpartum women offers superior clinical improvement and higher patient satisfaction. Therapy selection should consider the patient’s reproductive status to ensure optimal safety and efficacy.

Background: Pregnancy-associated dermatoses (PADs) include specific skin disorders unique to pregnancy and physiological changes influenced by hormonal and immunological shifts. Timely recognition of these conditions is essential for optimal maternal and fetal outcomes. This study aimed to evaluate the prevalence and clinical profile of PADs among Indian pregnant women. Methods: A cross-sectional observational study was conducted at a tertiary care centre in South India over one year. A total of 412 pregnant women attending the antenatal outpatient department were recruited. Detailed obstetric history, dermatological examination, and relevant investigations were performed. PADs were categorized into specific dermatoses and physiological/nonspecific dermatoses. Results: Out of 412 women, 157 (38.1%) were diagnosed with pregnancy-associated dermatoses. Among specific PADs (n = 157), the most common was Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) in 64 women (40.8%), followed by Prurigo of Pregnancy in 35 (22.3%), Intrahepatic Cholestasis of Pregnancy (ICP) in 27 (17.2%), Atopic Eruption of Pregnancy in 19 (12.1%), and Pemphigoid Gestationis in 6 (3.8%). The highest prevalence was in the third trimester with 91 cases (57.9%), followed by the second trimester with 51 (32.5%) and first trimester with 15 (9.6%). Obstetric complications were noted in cases of ICP, including preterm labour in 6 (22.2%) and fetal growth restriction in 4 (14.8%). Conclusion: PADs were observed in over one-third of the pregnant women, with PUPPP being the most frequent. While most cases were benign, certain dermatoses such as ICP showed associations with adverse pregnancy outcomes. Early dermatological screening is recommended for prompt diagnosis and management

Vernal keratoconjunctivitis (VKC) is a complex, Th2 cell-mediated inflammatory condition of the ocular surface that primarily affects males, particularly children and young adults. This condition involves an overactivity of immune cells, including mast cells, eosinophils, and Th2 cells, along with increased levels of cytokines, chemokines, and adhesion molecules. The main aim the study is the detect the efficacy of sodium cromoglycate, lodoxamide and loteprednol in treatment of Vernal keratoconjunctivitis (VKC). Methods randomized; comparative study was conducted on patients visiting the OPD at tertiary care hospital. The study included 150 patients diagnosed with VKC (vernal keratoconjunctivitis), patients were divided into three groups based on randomisation. Group A 50 patients treated with sodium cromoglycate Group B 50 patients treated with lodoxamide and group C patients treated with loteprednol, administered twice daily for 8 weeks. The reduction in signs and symptoms in groups was compared. White blood counts were measured for all patients before and after the treatment. Observations and results were systematically tabulated, and data were analysed using SPSS software. An unpaired t-test was used to determine statistical significance between the three groups, with a P-value < 0.05 considered statistically significant. Results: The study population included 150 patients, with 108 (72%) aged 5-10 years and 42 (28%) aged 11-15 years. Among them, 98 (65.3%) were male and 52 (34.7%) female. Shield ulcer was the most common symptom in patients with Vernal keratoconjunctivitis (VKC), occurring in 94.7% of cases, followed by sticky mucous discharge in 88% of patients. Infection was associated with elevated white blood cell count and CRP levels, as well as increases in neutrophils, eosinophils, and CRP. After treatment, improvements were noted in neutrophils, and significant changes were seen in basophils and CRP by the third visit (p = 0.005). Average CRP levels were monitored across all three treatment groups, alongside eosinophil and neutrophil counts. Conclusion for the treatment of vernal keratoconjunctivitis (VKC) mono drug therapy of sodium cromoglycate, lodoxamide and loteprednol shows significant improvement in treatment of Vernal keratoconjunctivitis (VKC).

Background Chronic Suppurative Otitis Media (CSOM) is a persistent middle ear and mastoid cavity infection characterized by ear discharge and tympanic membrane perforation. Its prevalence is higher in developing nations due to factors such as malnutrition, overcrowding, and inadequate healthcare. The emergence of multidrug-resistant pathogens has posed challenges in the management of CSOM, necessitating regular updates on microbial patterns and antibiotic susceptibility. Objective: This study aimed to evaluate the microbial diversity and antibiogram of aerobic bacterial, anaerobic, and fungal isolates in patients with CSOM attending a tertiary care hospital. Methods: A six-month prospective study was conducted on 102 clinically diagnosed CSOM patients who had not received antimicrobial therapy in the preceding seven days. Ear discharge samples were collected and processed for aerobic, anaerobic, and fungal cultures using standard microbiological protocols. Antimicrobial susceptibility testing for aerobic isolates was performed using the Kirby-Bauer disc diffusion method, and results were analyzed per CLSI guidelines. Results: Among 102 patients, 57.8% of cases were monomicrobial, 33.3% polymicrobial, and 7.8% sterile. Aerobic isolates included *MSSA* (48.04%), *Pseudomonas aeruginosa* (19.61%), and *Klebsiella pneumoniae* (8.82%). Anaerobic isolates accounted for 22 cases, with *Clostridium* and *Peptococcus species* being the most common (7.35% each). Fungal isolates were identified in 18 cases, predominantly *Aspergillus niger* (14.58%) and *Aspergillus fumigatus* (12.50%). Antimicrobial susceptibility testing revealed high sensitivity of *MSSA* to amikacin and cefuroxime, whereas *Pseudomonas aeruginosa* exhibited variable resistance patterns. Conclusion CSOM significantly impacts the quality of life, particularly in developing nations. The study highlights the importance of monitoring microbial trends and antibiotic susceptibility to guide effective management. Efforts to educate high-risk populations, especially parents and guardians of children, may help reduce disease burden. The findings provide valuable insights into the microbiological profile and resistance patterns in CSOM, aiding in its effective treatment and prevention.

The coronavirus disease-2019 (COVID-19) pandemic has been reported across all continents and the disease is growing at a very brisk pace, both in terms of the number of reported cases and the attributed deaths.It is important to note that the novel viral infection has been reported in 213 nations and territories. As per the recent estimates, a cumulative caseload of 2,314,621 cases and 157,847 deaths has been reported globally since the outbreak begun in a single city in China. The worst affected area has been the European region, wherein 1,149,071 cases has been reported and even the number of reported deaths (103,586) has clearly exceeded the number of deaths reported across the other 5 regions cumulatively.The disease already has attained pandemic status and is a global health emergency that has impacted the lives of all the stakeholders and will require an aggressive and a dedicated response from all the stakeholders to flatten the epidemic curve of the disease.

Introduction Furcation involvement is a unique pathological entity, due to its complex structure and inadequate instrumentation which results in progression of further attachment loss with early and frequent loss of molars. Various alloplastic bone graft materials are used to regenerate the lost periodontal attachment apparatus. This study aims to compare the efficacy of nanocrystalline hydroxyapatite (NHA) and bioactive calcium phosphosilicate grafts (BG) in the treatment of class II furcation defects. Methods Twenty-four systemically healthy patients with class II furcation defects were selected and randomly assigned into three groups depending on the treatment received: Test group I (treated with open flap debridement (OFD) + NHA), Test group II (treated with OFD + BG) and Control group (treated with OFD alone). Clinical parameters, plaque index, gingival index, horizontal probing depth (HPD), vertical probing depth (VPD), clinical attachment level (CAL) were recorded at baseline, 3 and 6 months post-surgically. Radiographic depth of furcation defect (FD) and percentage bone fill was evaluated at baseline and 6 months postoperatively. Results When compared to baseline, all three groups demonstrated improvements in the clinical parameters at 6 months. There was no statistically significant difference between both Test groups (p=1.00). In contrast to the Control group, the Test groups showed a statistically significant reduction in probing depth, greater CAL gain, reduction in furcation defect and radiographic percentage bone fill (p<0.05). Conclusions There is a potential benefit of nano-crystalline hydroxyapatite and bioactive calcium phosphosilicate grafts in percentage bone fill in the treatment of class II furcation defects.

Introduction Ventilator associated pneumonia (VAP) is one of the most frequent intensive care unit (ICU) acquired infections. In recent years there has been an increase in antibiotic resistance among causal agents of VAP. This study was carried out to assess the profile of culture isolates and their antimicrobial sensitivity from the endotracheal aspirates (ETA) of patients with clinically suspected ventilator associated pneumonia. Methods In this observational study, ETA was collected from patients who were on mechanical ventilation for >48 hours in the ICU with clinically suspected VAP. Samples were mechanically liquefied, homogenized and serially diluted for quantitative culture. Identification and antibiotic sensitivity of the isolate was performed using Vitek2 (BioMérieux, Marcy-l'Étoile, France). Results We received a total of 196 tracheal aspirates during the study period, out of which 100 samples showed growth. The most common isolate was A. baumannii (38%) followed by K. pneumoniae (33%). Among the Enterobacteriaceae group of organisms isolated (n=41), 37 isolates (90%) were extended spectrum beta lactamase (ESBL) producing organisms and 35% were metallo-β-lactamases (MBL) producers. All Staphylococcus aureus (n=3) isolates were methicillin resistant (MRSA). Conclusions Multidrug resistant organisms are now commonly reported from patients with VAP in our ICUs. A majority of the organisms were sensitive only to tigecycline and colistin. Our data suggest the need for strengthened infection control efforts in the intensive care unit, and for reevaluating compliance with the antibiotic stewardship programme.

Introduction Over the years, many studies concerning the articular eminence (AE) of the temporomandibular joint (TMJ) have been conducted. Very few used the now available cone-beam computer tomography (CBCT) technology. Thus, the aim of the current study was to contribute with our own findings to the recent available literature and to compare results. Methods Forty-eight CBCT files (96 TMJs) were analyzed in mid-condyle orthogonal plane. AE inclination (AEI), length of condylar path (LCP), length of the glenoid fossa (FL), sex and occlusion class were defined as parameters. Results In the examined lot, 9% of the slopes were below 30°, 70% between 30° and 50° and 21% above 50°. A minimum value of 21.63° was found in a female patient with a LCP of 11.07 mm and a FL of 19.96 mm, and a maximum value of 59.62° in a male patient with a LCP of 7.72 mm and a FL of 14.39 mm. A decrease in mean LCP and FL values for each increase in AEI category was noticed. Averages of both sexes were similar. Asymmetry was found in all patients. There were some differences between the two occlusal groups. Conclusions CBCT is a useful, non-invasive tool in analyzing TMJ bone structures. There might be a connection between AEI, LCP and FL in dictating the geometrical shape of the glenoid fossa. Differences in the values of the occlusal groups denote that occlusion could act as a factor for slope steepness.

One of the most famous quotes of Rudolf Virchow, a German researcher in Cell Biology, urges us to "learn to see microscopically”. In this complex situation that the world is facing nowadays, it seems vital to return to these words and complete them by adding that we should think globally, as well. The humanity encountered and won battles against many pathogens, such as Yersinia pestis, Mycobacterium tuberculosis or Variola viruses. However, at this moment in time we are confronted with multiple epidemics simultaneously. For instance, Romania is fighting both the COVID-19 pandemic and the measles epidemic. While the former is driven by an emerging virus, the latter is driven by a well-known virus, and one of the reasons behind the current epidemic is the parents’ hesitancy in immunizing their children through vaccination, as a result of misleading information in social media.