Background: Chronic subdural hematoma (CSDH) is a common neurosurgical condition, especially among the elderly, and is managed primarily through burr hole evacuation with postoperative drainage. Objective: To compare the postoperative inflammatory response and clinical recovery between subperiosteal and subdural drainage techniques in patients undergoing burr hole surgery for CSDH. Methods: A total of 80 patients diagnosed with chronic subdural hematoma were included in this study. The patients were divided into two groups: one group (n=40) received subperiosteal/subgaleal drainage, and the other group (n=40) underwent subdural drainage. Results: On POD 1, patients in the subperiosteal group had significantly lower CRP (22.4 ± 5.6 vs. 31.7 ± 7.2 mg/L, p<0.001), IL-6 (18.9 ± 4.5 vs. 27.2 ± 6.1 pg/mL, p<0.001), TNF-α (12.1 ± 3.1 vs. 16.3 ± 3.9 pg/mL, p<0.001), and WBC counts (9.4 ± 1.8 vs. 11.2 ± 2.3 ×10⁹/L, p=0.002) compared to the subdural group. Similar trends were observed on POD 3. The subperiosteal group also demonstrated faster ambulation (2.1 ± 0.6 vs. 3.4 ± 1.1 days, p<0.001), shorter hospital stay (4.3 ± 1.2 vs. 5.9 ± 1.5 days, p<0.001), and fewer febrile episodes (10% vs. 35%, p=0.008). Conclusion: Subperiosteal drainage following CSDH surgery is associated with a significantly lower postoperative inflammatory response and faster physiological recovery compared to subdural drainage. These findings support the use of subperiosteal drainage as a more physiology-conserving and clinically effective alternative in the postoperative management of CSDH.

Background: Pulmonary tuberculosis (PTB) continues to pose a substantial public health burden in India, which accounts for a significant share of global TB cases. Effective management of PTB is crucial, particularly in urban centers with dense populations and increased transmission risk. This study assesses the effectiveness of standardized anti-tubercular therapy (ATT), evaluates treatment outcomes, and identifies factors influencing therapy adherence and response in a tertiary care setting in Bangalore. Methods: A prospective observational study was conducted from December 2020 to March 2021 involving 200 patients with microbiologically confirmed PTB. Patients received first-line ATT under the Revised National Tuberculosis Control Program (RNTCP). Clinical parameters, demographic data, treatment adherence, and adverse drug reactions were recorded and analyzed using SPSS v25. Follow-ups were conducted monthly, and sputum conversion rates were assessed at the end of the intensive phase (2 months). Results: The cohort had a mean age of 42.5 ± 12.3 years, with a male predominance (62%). Comorbidities included diabetes (18%) and hypertension (14%). At the end of the intensive phase, sputum conversion was achieved in 78% of patients. Overall treatment success rate stood at 85%, while 8% defaulted, and 7% had evidence of drug resistance. Adverse drug reactions were observed in 22%, with hepatotoxicity being the most prevalent. Conclusion: Standardized ATT remains effective for PTB management. However, adverse effects, particularly hepatotoxicity, pose challenges. Continuous monitoring, patient education, and individualized care are essential for improving outcomes and supporting national TB elimination goals.

Background: Surgical site infections (SSIs) are a major complication in abdominal surgery, increasing morbidity and healthcare costs. Preoperative antibiotic prophylaxis (PAP) is widely recommended, yet its efficacy in resource-limited settings like India remains understudied. This study evaluated PAP’s impact on SSI incidence in abdominal surgery patients. Methods: A prospective cohort study was conducted with One hundred patients undergoing abdominal surgery were randomized into two groups: 50 received a single 1 g intravenous dose of Ceftriaxone 30–60 minutes before incision (PAP group), and 50 received no prophylaxis (control group). The primary outcome was SSI incidence within 30 days, classified per CDC criteria. Secondary outcomes included hospital stay, non-SSI complications, and adverse events. Statistical analyses used chi-square, Fisher’s exact, and Mann-Whitney U tests (p < 0.05). Results: SSI incidence was 10% (5/50) in the PAP group versus 20% (10/50) in the control group (p = 0.037), with a 50% relative risk reduction. Superficial SSIs predominated (66.7%), with no significant subtype difference (p = 0.15). Escherichia coli (46.7%) and Staphylococcus aureus (26.7%) were common pathogens (p = 0.72). Median hospital stay was shorter in the PAP group (6 vs. 7 days, p = 0.04). One mild allergic reaction occurred in the PAP group; no Clostridium difficile infections were noted. Conclusion: PAP significantly reduced SSI incidence and hospital stay in abdominal surgery, supporting its use in this setting with minimal adverse effects.

Introduction The two-stage revision technique is the most frequently used method for the treatment of prosthetic joint infection (PJI). It needs the use of a temporary bone cement spacer loaded with different types of antibiotics. Gentamicin and vancomycin are often used in cement spacers, alone or in association with other antibiotics, but there is no consensus on the concentrations and the period of time that they should be used. Therefore, the purpose of this study was to compare the antibiotic elution in time between gentamicin and vancomycin, to see for how long the cement retains antimicrobial activity. Methods We used two types of antibiotic-loaded acrylic cement (polymethylmethacrylate – PMMA). One was prefabricated, containing 40 g of cement powder and 2 g of gentamicin. The second one was handmade containing 40 g cement powder and 2 g of vancomycin. Every day, we took two cement tablets, one with vancomycin and one with gentamicin and transferred them to a Mueller Hinton E (MHE) culture environment previously inoculated with 0.05 McFarlandStaphylococcus aureus reference strain ATCC 25923. The dish was incubated at 37°C for 24 hours, after which the sample was read, measuring the inhibition area around the cement tablet. We read the results daily, by measuring the inhibition area around the cement. Results For both types of cement the maximum inhibition area was recorded in the first day and it measured 16/17 mm in the vancomycin cement and 34/40 mm in the gentamicin cement. Both antibiotics had good minimal inhibition concentration (MIC) in the first 6 weeks of the study. We obtained inhibition areas exceeding 10 mm around the cement in the first 45 days. In the 60th day, the inhibition area around the gentamicin cement started to decrease progressively under 10 mm and on the 64thday it disappeared completely. Regarding the vancomycin cement, the inhibition area started to decrease from the 66th day, until becoming completely absent on the 68th day. Conclusions For both types of antibiotic cement, we obtained a bactericidal effect (an area of inhibition) in first 8 weeks of the study. Maintaining a spacer in place for more than 8 weeks could bring no benefit. On the contrary it might allow bacteria to adhere and form a biofilm, making the antibiotherapy useless after 8 weeks, if the pathogenic agent is still present.

Introduction The main objective of this study was to determine the quality of life (QoL) of undergraduate medical students and its associations in face of the COVID-19 pandemic. Methods This was a cross-sectional study conducted by an online survey using the World Health Organization Quality of Life tool (WHOQOL-BREF). Results A total of 281 completed responses were obtained with an average age of 22.3±3.9 years and 77.5% were female. The scores of physical, psychological, social and relationship and environmental WHOQOL-BREF domains measuring quality of life were 62.7±16.5, 54.9±18.7, 59.8±22.3 and 61.4±17.5, respectively, which were independent of gender. QoL mean scores were significantly lower for dental students compared to their medical counterparts in all domains (p<0.05 for all). Final year (year 5) students had a significantly smaller mean physical domain score when compared to year 4 students (56.2±15.8 vs. 68.8±17.2, p=0.008) Being a foreigner was associated with reduced odds of self-reported good QoL compared to local students (OR: 0.39, 95%CI: 0.16-0.94). There were statistically significant decreases in mean psychological and environmental scores in 2020 compared to a similar pre-COVID19 survey done in 2019 (p<0.001 for all). Conclusions Dental, foreign, and final year students emerged as high-risk groups in this study on reduced quality of life. Additionally, the COVID-19 pandemic also contributed to reductions in environmental and psychologic quality of life. Screening of students is advocated to identify those who may benefit from supportive interventions.

More than a year since the start of the COVID-19 pandemic, the global administration of the COVID-19 vaccines hopes to confer sustained protection against SARS-CoV-2 and stop this difficult to predict situation. They are highly effective, especially at preventing the severe form of disease and reducing the death rate from COVID-19. Pregnant women represent a high-risk category of population for infectious diseases, including COVID-19, and need to be considered for vaccination. Because the results of clinical trials of COVID-19 vaccines in pregnant women are not yet published, many questions remain to be answered. There are now available data and information in real-life data, including healthcare pregnant women or in women who did not know they were pregnant at the time of vaccination. This work aims to present the current state of knowledge about COVID-19 vaccines during pregnancy based on reported cases from medical literature. These cases of COVID-19 vaccination will be more and more, and in the future, we will be supplementarily adding data about the benefits and effects of vaccination on pregnancy, fetal and infant development, and their immunity. Today we affirm: anti-COVID-19 vaccines during pregnancy are reported to be as safe and effective as in the general population. Because a higher rate of miscarriage in early pregnancy has been observed to be associated with COVID-19, it may seem sagacious to recommend vaccination before planning a pregnancy to gain immunity at the time of conception.

Psoriasis is a chronic inflammatory disease characterized by aberrant keratinocyte differentiation and hyperproliferation. In psoriasis, there is an abnormal cross-talk between keratinocytes and CD4+lymphocytes, that leads to overproduction of cytokines and persistent inflammation. Alcohol consumption is one factor related to the onset of the grade of severity of psoriasis lesions. More than an inflammatory disease, psoriasis could be triggered by severe comorbidities, rather than being associated with them only, such as metabolic syndrome, cardiovascular disease and diabetes mellitus, which can negatively affect alcohol intake. On the one hand, whether alcohol is a trigger / aggravating factor in psoriasis, and on the other hand, whether the condition itself determines the person to higher alcohol consumption and the risks to which he is exposed in this situation. We want to emphasize that excess intake of alcohol will contribute to worsening skin and joints lesions of psoriasis. Medical history and patient complaints related toalcohol consumption and alcohol dependency can be of substantial importance for managing this complex disease. Therefore, detecting and treating alcohol consumption can improve psoriasis prognosis.

Antimicrobial resistance (AMR) represents a major threat to health and to healthcare. With worrisome rates of AMR, the World Health Organization has warned about the threat of returning to the pre-antibiotic era unless risk reduction interventions are taken urgently. While the epidemiology of multidrug-resistant (MDR) germs is different in different parts of the world, each country, each region and each hospital need a good understanding of their own resistance rates to the most commonly used antimicrobials for the pathogens that are most often involved in clinically-significant infections. Surveillance of AMR uses multiple different techniques and multiple data collection sources, which at times might lead to heterogenous results and non-comparable patient populations, making it hard to generalize the data for a specific region or for a specific pathogen.