bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comprehensive Helicopter Acoustic Modeling Tool Based on Simulation and Experiment
Authors:   Airbus Helicopters, Guntzer Frederic , Caillet Julien , Pinacho Jean-Paul , Dieumegard Pierre , Leon Enric
Published: May 2024

The paper describes activities currently run in the frame of the MOTUS project. The developed methodology allows to correct an acoustic measurement database from simulation results in order to model the noise emission of a new helicopter (H/C), accounting for the introduction of low-noise technology bricks (e.g. rotational speed modification, alternate main rotor blade or Fenestron™ design, engine noise control treatment...). The resulting hemisphere database can then be used to simulate various use-cases, from predicting certification noise levels to computing noise footprints on realistic scenarii, including also Low Noise Procedures. All these results can then be auralized in a subsequent step, to address advanced metrics related to noise annoyance.
Pathological and immunohistochemical findings of lungs, heart, liver, and kidneys, and unexpected findings of fungi and parasites in lungs of deceased COVID-19 patients: A case series
Authors: Yakar Mehmet N. , Ergün Bişar , Erol Aylin , Gökbayrak Özde , Aktaş Tekincan Ç. , Ulusan Bağcı Özlem , Bayraktar Fırat , Uçan Eyüp S. , Ergan Begüm , Cömert Bilgin , Caner Ayşe , Aktaş Safiye , Gökmen Ali N.
Published: May 2024

Objective:

To define histopathologic and immunohistochemical features of the lungs, heart, liver, and kidneys in patients who died from coronavirus disease 2019 (COVID-19), and to determine the presence of SARS-CoV-2 in all tissues, as well as the presence of fungi and parasites in lung tissues.

Methods:

This retrospective case study was conducted in the intensive care units of Dokuz Eylül University Hospital, and patients (≥18 years) who died due to COVID-19 between October 2020 and April 2021 were included. The biopsy samples of the patient's lung, heart, liver, and kidney tissues were studied.

Results:

In the study, we enrolled 12 patients (mean age: 70 years; 50% male). Alveolar epithelial cell damage and diffuse alveolar damage were predominant in lung tissues. Lobular lymphocyte infiltration, centrilobular sinusoidal dilatation, and microvesicular steatosis in the liver, together with pigmented cast, non-isometric vacuolar degeneration, and capillary plugging in the kidneys, were commonly found among the patients. SARS-CoV-2 nucleocapsid protein antibodies were detected in three lung and two kidney tissues, and so did angiotensin-converting enzyme 2 receptor positivity in one lung and more than half of the kidney tissues. The RT-PCR tests were positive in three lungs and one kidney tissue. After DNA isolation from lung tissues, Pneumocystis jirovecii was detected in nine patients, Aspergillus fumigatus in two, Microsporidia in three, and Cryptosporidium in two.

Conclusions:

SARS-CoV-2 is a multisystemic disease. Fungi and parasites should be investigated in critically ill COVID-19 patients prescribed corticosteroids.
Phimosis – Are we on Right Track?
Authors: Manekar Aditya Arvind , Janjala Narahari , Sahoo Subrat Kumar , Tripathy Bikasha Bihary , Mohanty Manoj Kumar
Published: May 2024

Background:

Phimosis, a common paediatric condition, is defined as the inability to retract the preputial skin behind the glans. Current practice shows there is some confusion among the paediatricians towards this common condition and in differentiating it from the more common physiological preputial adhesion; leading to frequent referrals to a paediatric surgeon or a general surgeon, which can be addressed by the parents and the child physicians themselves.

Aim:

To find out the awareness towards the management of phimosis among the paediatricians.

Materials and Methods:

A questionnaire on this topic was generated using ‘Google Forms’ and was circulated among junior and senior residents, faculty in various medical colleges and consultants in private practice all over India and their response was collected and analysed.

Results:

We received a total of 221 responses from all over India from paediatric medicine trainees and consultants. Among them, majority (48%) were senior residents. According to the survey participants, the most (46%) find inability to retract the prepuce as the major presenting complaint. A straight away reference to a paediatric surgeon was preferred by majority of paediatricians (62.9%), though most of them were aware of them were aware of physiological adhesions and conservative management (94.2%). There was a belief among 43% about counselling each and every patient presenting with phimosis for circumcision. Among the respondents, 60.2% advised ultrasound of kidneys, ureter, and bladder to their patients and believed that backpressure changes alter the management of the child. A urine routine examination was advised by 70.1% of participants, with 46.6% believing that the presence of urinary tract infection changes the management of phimosis. Waiting up to 1 year of age before going for surgery was advocated by 71.5%. A major proportion of respondents (76%) believed all cases of phimosis should be referred to a surgeon, only 58.8% would voluntarily follow them up. There is still a belief among 69.7% of participants that all cases of phimosis should be referred to a paediatric surgeon and only few of them, 5.4% feel referring only indicated cases.

Conclusion:

Physiological phimosis is a common condition which can be addressed by the paediatricians themselves. Awareness is to be increased among them, especially during the training period regarding the proper management of this common condition, avoiding unnecessary circumcisions.
Hypothyroidism Following Sistrunk Procedure
Authors: Elechi Hassan Abdullahi
Published: May 2024

Thyroglossal duct cyst is the most common cause of anterior midline neck swelling in children, but ectopic thyroid is an important but rare differential diagnosis. Establishing the orthotopic thyroid gland status is crucial as inadvertent removal of a lone functioning ectopic thyroid tissue in young children could lead to fluttering of growth and development if not identified early. We report the case of a 2 years 10-month-old boy who had Sistrunk's procedure for 'thyroglossal duct cyst': Diagnosed using USS, defaulted follow-up and presented subsequently with growth retardation from hypothyroidism.
A Case of Ovarian Fibromatosis as an Incidental Finding in an Acute Ovarian Torsion
Authors: Costoya Cristina Pérez , Torre Francisco Vicario La , Salinas Lucas Krauel Jiménez , Farpón Ángela Gómez , Muñoz Víctor Álvarez
Published: May 2024

Ovarian fibromatosis (OF) is a rare non-neoplastic condition, more frequent in young females and characterised by ovarian enlargement with proliferation of collagen-producing spindle cells in the stroma. It usually presents with abdominal pain, menstrual disorders or as a solid mass. Hirsutism and virilisation are possible. The relevance of this subject remains in the usual misdiagnosis as a malignant tumour, which may lead to unnecessary oophorectomies. We report the case of a 17-year-old female who presented with acute intense pain in the right iliac fossa and vomits. On examination, she complained of intense pain without any signs of peritonism. An abdominal ultrasound was performed, finding an enlarged right adnexal containing a heterogenic cyst without flow to the ovary. A Pfannenstiel laparotomy showed a right ovarian torsion. The haemorrhagic cyst was drained and the ovary was detorsed. Bilateral ovarian biopsies were performed as both ovaries showed an indurated and cerebroid surface, suggestive of malignancy. Tumoural markers were negative. Histological examination confirmed OF. After 3 months, the magnetic resonance imaging showed an enlarged right ovary with a fibrous capsule surrounding both ovaries. In conclusion, OF can also be found incidentally in the context of an ovarian torsion. Since its appearance may be dismissed as malignant, it is important to recognise it and remain conservative. Biopsies can be taken to make the differential diagnosis.
Neutropaenic Enterocolitis
Authors: Israel Aina Yetunde Tinuola , Emordi Victor Chekwube , Osagie Osasumwen Theophilus
Published: May 2024

Neutropaenic enterocolitis (NE) is a life-threatening condition characterised by an inflammation of the colon and/or the small bowel in the background of chemotherapy-induced neutropaenia. A 16-year-old girl with acute myeloblastic leukaemia (AML) developed fever, right-sided abdominal pain and tenderness with severe neutropaenia. Initial ultrasound findings suggested acute appendicitis for which she had surgery. She developed recurrent symptoms 3 weeks later. Abdominal computed tomography (CT) scan showed features of NE, but she succumbed to the illness. Another 17-year-old boy with AML developed fever and severe right-sided lower abdominal pain and tenderness, following completion of induction chemotherapy. He was neutropaenic and abdominal CT was typical of NE. He was managed nonoperatively and symptoms resolved. The diagnosis of NE can be a dilemma. A high index of suspicion is needed to avoid a misdiagnosis of acute appendicitis.
Complicated Duodenal Perforation in Children
Authors: Keshri Rupesh , Chaubey Digamber , Yadav Ramdhani , Kumar Vijayendra , Thakur Vinit Kumar , Ranjana Rashmi , Rahul Sandip Kumar
Published: May 2024

Background:

Diagnosis of duodenal perforation (DP) in children is often delayed. This worsens the clinical condition and complicates simple closure.

Objectives:

To explore the advantages of using T-tube in surgeries for DP in children.

Patients and Methods:

A retrospective study was conducted on all patients of DP managed in the Department of Paediatric surgery at a tertiary centre from January 2016 to December 2020. Clinical, operative and post-operative data were collected. Patients, with closure over a T-tube to ensure tension-free healing, were critically analysed.

Results:

A total of nine DP patients with ages ranging from 2 years to 9 years were managed. Five (55.6%) patients had blunt abdominal trauma; a 2-year-old male had perforation following accidental ingestion of lollypop-stick while a 3-year-old male had DP during endoscopic evaluation (iatrogenic) of bleeding duodenal ulcers; cause could not be found in other 2 (22.2%) patients. Of the five patients with blunt abdominal trauma, 4 (80%) had large perforation with oedematous bowel, necessitating repair over T-tube. Both patients with unknown causes had uneventful outcomes following primary repair with Graham's patch. Patients with lollypop-stick ingestion and iatrogenic perforation did well with repair over T-tube. The only trauma patient with primary repair leaked but subsequently had successful repair over a T-tube. One patient with complete transection of the third part of the duodenum and pancreatic injury who had repair over T-tube died due to secondary haemorrhage on the 10th post-operative day.

Conclusion:

Closure over a T-tube in DP, presenting late with oedematous bowel, ensures low pressure at the perforation site, forms a controlled fistula and promotes healing, thereby lessening post-operative complications.
Effectiveness of biologic treatment for psoriasis in Malaysia: Real-world evidence and review of current evidence from Southeast Asia
Authors: Kwan Zhenli , Voo Sook Yee Michelle , Tan Wooi Chiang , Tang Jyh Jong , Tang Min Moon , Abdullah Wan Noor Hasbee Wan , Selvarajah Latha R. , Ng Ting Guan , Ramalingam Rajalingam , Muniandy Pubalan , Han Winn Hui , Yong Shin Shen , Robinson Suganthy ,   The Malaysian Psoriasis Registry Working Group
Published: May 2024

Background:

Biological treatments are effective in the management of psoriasis. However, results in the real-world setting may differ from clinical trials.

Objectives:

We aimed to evaluate the effectiveness of biological drugs among patients with psoriasis in Malaysia.

Methods:

This was a retrospective review of adult patients on biologics who were notified to the Malaysian Psoriasis Registry between 2011 and 2019. Univariate and multivariate logistic regression was performed to identify factors associated with response to treatment in terms of the Psoriasis Area and Severity Index (PASI) 75, PASI 90, and Dermatology Life Quality Index (DLQI) 0/1.

Results:

Of 130 patients, the most prescribed drug was ustekinumab (40.8%), followed by adalimumab (29.2%) and secukinumab (24.6%). Overall, the differences in the median PASI scores from baseline were −23.9 at 3–6 months, −25.8 at 12 months, and −27.8 at 3 years, while the difference in the median DLQI scores was −13.0 at 3–6 months. At 3–6 months, 57.6% achieved PASI-75, 32.9% achieved PASI-90, and 4.7% achieved PASI-100. These responses were sustained at 12 months and 3 years. Adalimumab was the most effective treatment with 88.9% achieving PASI-75, 77.8% PASI-90, and 22.2% PASI-100 at 3 years. However, secukinumab was more effective at achieving a PASI-100 response at 3–6 months (9.1%). Chinese or Indian ethnicity, concurrent use of systemic therapy or phototherapy, comorbidities, and a longer duration of psoriasis were associated with poorer response.

Conclusion:

Biological treatments, particularly adalimumab and secukinumab, are effective in reducing disease severity and improving the quality of life of patients with psoriasis in Malaysia.
Blindness due to Landmine Blast Injury
Authors: Hegde Rajarathna V. , Shinde Chhaya A. , Shetty Sushmitha S. , Khan Afzal T.
Published: May 2024

This case report describes a case of ocular blast injury and its management. A 35-year-old male patient was referred to a tertiary hospital with a history of landmine blast injury. The right eye examination revealed full-thickness lacerated wound in the right upper eyelid and globe rupture. The left eye examination revealed a partial-thickness scleral tear, multiple foreign bodies in the cornea, foreign body embedded in the iris, and traumatic cataract. The evisceration of the right eye with scleral tear repair in the left eye was performed under general anesthesia. Multiple foreign bodies from the cornea and one embedded in the iris were removed from the left eye. At the final follow-up at 3 months, the right socket showed a good healing with an implant in place. The visual acuity in the left eye was 6/24 with foreign bodies in the deeper corneal stroma and traumatic cataract.
A microintensive research study: The impact of yoga on posture, breathing, and psychosocial variables in young adults with cerebral palsy
Authors: Rangwala Shabnam , Sneyd Katherine
Published: May 2024

The objective of the study was to demonstrate physical and psychosocial impact of yoga on adults with cerebral palsy (CP). This study was a pre–post intervention study involving 12 adults with CP selected with purposive sampling method. The participants received individualized interventions planned by a special yoga specialist for 10 months. Along with the Yoga intervention they underwent traditional physiotherapy sessions on a once-a-week basis. The participants were evaluated on the following parameters: breathing capacity, posture and physical measurements, and psychological impact. Breathing capacity was assessed using the calibrated spirometer where the maximum volume of air inspired was measured. Chest expansion measurements at rest and full inspiration were recorded at apex of axilla and at xiphoid process. The length of time of Om chanting was recorded in seconds. Physical assessments were done by measuring height, weight, body mass index (BMI), and girth of arm and thighs and a postural assessment against a postural grid. The psychosocial impact was measured using the Depression Anxiety and Stress Scale 21 items (DASS-21). There was no significant effect on BMI (P = 0.404; paired t test). There was significant improvement in the vital capacity (P = 0.04; paired t test) three ball spirometer (P = 0.003; paired t test), Om chanting (P = 0.0001; paired t test), and chest expansion at axilla and xiphoid process (P = 0.0004 and 0.002, respectively; paired t test). DASS-21 scores also showed significant differences (anxiety, P = 0.02; stress, P = 0.07; and depression, P = 0.06). It can, therefore, be concluded that yoga intervention does not impact the physical parameters of young adults with CP. It shows a positive impact on the vital capacity parameters and it also has a positive psychological impact.
Bilateral Facial Palsy in Cerebral Venous Sinus Thrombosis – An Uncommon Association
Authors: Mishra Ajit Prasad , Mallick A K , Nayak S D , Sahoo L K
Published: May 2024

Background:

Cranial nerve palsy in cerebral venous sinus thrombosis (CVST) is not a very common presentation, its pathophysiology is not well understood.

Case Description:

We report a 27 year old young man with CVST having protein-S deficiency & hyperhomocystinemia, who during his initial days of hospitalization developed bilateral facial palsy. With conservative treatment of CVST, complete recovery of facial palsy occurred with recanalization of transverse sinus.

Conclusions:

Facial palsy in this patient was probably caused by transient neurapraxia in the intracranial segment of the nerve. It may be hypothesised that elevated venous transmural pressure in the nerve's satellite vein, which belongs to the affected drainage territory of the transverse sinus, might have caused venous blood-brain barrier dysfunction in the intrinsic vascular system of the nerve, with leakage of fluids and ions into the endoneurial space and thus an increase in interstitial resistance causing conduction defects.
Revised Socioeconomic Status Scales for the Year 2021
Authors: Sahu Monalisha , Das Arpita , Chattopadhyay Biswadip , Paul Bobby , Bhattacharyya Madhumita
Published: May 2024

Context:

Most of the public health and medical research include economic and social status as one of the pertinent predictors for health-related variables at the individual or family level. Modified B. G. Prasad scale (1961) and Modified Kuppuswamy scale (1976) are two of the most widely used socioeconomic status scales in India for health and social research. The income ranges in these scales need a frequent update with a rapidly growing economy and changing consumption patterns with time.

Aim:

This study revised the Modified Kuppuswamy and B. G. Prasad scales by updating income ranges as per the latest consumer price index (CPI) numbers of industrial workers (IW) and latest base year (2016) extracted from the Labour Bureau, Government of India.

Methodology of the Study:

Multiplication and conversion factors were calculated using CPI-IW (base year 2016 = 100) and linking factor. Updated income ranges for the Modified Kuppuswamy scale were estimated after calculating the multiplication factor (MF) between the year 1976 and the present year, whereas linking factor 2.88 and MF 1.20 have been used to calculate the income limits for the Modified B. G. Prasad scale.

Results:

The updated income range of the Modified B. G. Prasad and Kuppuswamy scale was estimated to be 78.89 and 26.46 times the income range values of the original scales (1961 and 1976), respectively.

Conclusion:

This update is relevant and highly needed after the introduction of the latest series of the base year in 2020, without which the income ranges would have been overestimated if calculated with the previous series (Base year 2001 = 100).
A Case of Scrub Typhus Meningoencephalitis Complicated by a Rare Pathogen Leclercia adecarboxylata
Authors: Sahu Sanjay K. , Mishra Surya N. , Biswal Seba R. , Yerru Hari K. P. , Behera Chinmay K.
Published: May 2024

Leclercia adecarboxylata is Gram-negative bacteria and belongs to the family Enterobacteriaceae, which is motile and is considered as a commensal in normal gut flora. It causes opportunistic infection in immunocompromised hosts but also has been isolated from pus, blood, urine, and sputum of immunocompetent hosts. It is often found to be a part of polymicrobial infection indicating synergistic effect, enhancing its virulence. Rarely, it has been isolated from the cerebrospinal fluid of a child, and its coinfection with scrub typhus has hardly been reported. Because of significant morbidity and mortality associated with nosocomial infections, microbiologists and clinicians should be aware of such unusual pathogens such as L. adecarboxylata. Though most L. adecarboxylata isolates are sensitive to many of the antibiotics, their coexistence with multidrug resistant organisms could result in the transmission of resistance elements.
The Effect of Social Media on Awareness and Mental Health of People During COVID-19 Pandemic
Authors: Anand Puneet U. , Patil Sanjivani Vishwanath , Deshmukh Rupeshkumar Balasaheb
Published: May 2024

Background:

The lockdown and the pandemic has caused a lot of mental health problems and social media exposure plays a major role in it. At present, many myths about coronavirus transmission and prevention are being circulated through social media.

Objectives:

1. The objective of this study was to assess the awareness of COVID-19 among social media users2. To assess the prevalence of mental health problems using Stanford Acute Stress Reaction Scale and WHO-5 Well-Being Index and its association with social media exposure.

Materials and Methods:

An observational, cross-sectional study was conducted online. Participants were invited to take part in online survey using various social media platforms. Validated semi-structured questionnaire tool was used to collect data. Mental health status was assessed using the Stanford Acute Stress Reaction Scale and WHO-5 Well-Being Index. Multivariate logistic regression analyses were applied for adjusted odds ratio (OR) of outcome variables with different risk factors.

Results:

A total of 27 (9.93%) study participants suffered from acute stress disorder. A total of 118 (43.38%) study participants suffered from depression. Multivariate analyses found that adjusted odds of acute stress disorders were greater among those aged more than 60 years (Adj OR = 1.08), more in females (Adj OR = 1.31) as compared to males, and those with higher secondary education (Adj OR = 1.73). Depression was significantly more among individuals who either spent all or more than half of their time reading about COVID-19.

Conclusions:

Study findings indicate a need to pay more attention to mental health among the general population while combating with COVID-19.
A study of mini-CEX (mini-clinical evaluation exercise) as an assessment tool of postgraduate students in ophthalmology
Authors: Shinde Chhaya A , Shirwadkar Shruti P , Hegde Rajarathna V , D'Cunha Lynn L , Rao Priyanka R , Kokate Anupama A , Raghuwanshi Akash O
Published: May 2024

Background/Aim:

Postgraduate students of ophthalmology are not assessed in a structured and standardized way. By using the mini-clinical evaluation exercise (mini-CEX) method of assessment, the skills will improve in the students as they will get immediate feedback from the assessors to improve further. To assess the postgraduate students of ophthalmology in a structured manner and to ascertain whether their clinical skills improve due to mini-CEX as an assessment tool.

Materials and Methods:

Prospective.

Materials and Methods:

The study was performed over 5 months, including five postgraduate students. Each student was given 15 cases with set A assessor and 15 cases with set B assessor. Assessors and postgraduate students were trained by the first author about mini-CEX. Students were trained by the assessors about seven core clinical skills. Fifty clinical encounters were done in the first, third, and fifth month each. Students were assessed for the same seven core clinical skills by the assessors, and feedback was provided to students.

Results and Conclusion:

Differences in the successive assessments (improvements) were found statistically significant (P value < 0.05). Scores of postgraduate students improved in three assessments over 5 months.
Glans augmentation by pedicled inner preputial flap in distal penile hypospadias: A prospective interventional study
Authors: Tanger Ramesh Chand , Prajapati Sahaj , Saini Girish , Raipuria Gurudatt
Published: May 2024

Aims and Objective:

The aim of the study was to describe a modification in the tubularized incised plate (TIP) procedure that incorporates glans augmentation with the inner preputial flap in cases of distal penile hypospadias with small glans and shallow groove.

Materials and Methods:

This was a prospective interventional study conducted over a period of 1 year from July 1, 2021, to June 31, 2022, at the Department of Pediatric Surgery, SMS Medical College and attached SPINCH, Jaipur. All distal penile hypospadias patients with small glans and shallow groove were included in the study. Patients with failed repairs and having associated congenital conditions were excluded. All the included patients underwent hypospadias repair by the standard TIP technique, and a modification was added to augment the glans by inner preputial flap. The incidence of glans dehiscence and fistula formation along with cosmetic appearance was recorded.

Results:

A total of 25 patients were included, which comprised subcoronal (n = 14; 56%), distal penile (n = 7; 28%), and coronal (n = 4; 16%) hypospadias. There were no immediate or late postoperative complications. Follow-up periods were ranging from 4 months to 12 months. There was no meatal stenosis or urethra cutaneous fistula formation after 6 months of follow-up period. The cosmetic appearance and color of the glans were satisfactory after 6–12 months of follow-up.

Conclusions:

With this modification of the TIP procedure in patients with distal penile hypospadias having small glans and shallow groove, a good glans width with normally placed meatus without stenosis and fistula can be achieved.
The Past, Present, and Future of Dentistry through Lenses
Authors: Mukherjee Suman
Published: May 2024

This article discusses the scope of lenses and microscopes in dentistry. The modern advancements and prospects soon will change the course of dentistry.
Pyogenic Granuloma-Like Kaposi's Sarcoma on the Ear in an Immunocompetent Patient
Authors: Agharbi Fatima-Zahra , Albouzidi Abderrahmanne , Chiheb Soumiya
Published: May 2024

Botriomycome-like Kaposi disease is a rare clinical and pathological variant of Kaposi disease. Showing features of pyogenic granuloma (PG) and of Kaposi's sarcoma (KS), it was initially named KS-like PG and considered benign.[2] It is now considered a true KS and was renamed PG-like KS due to the clinical course and the presence of human herpes virus-8 DNA.[13],[14] This entity has been mostly described on the lower extremities, but other rare locations such as hand, nasal mucosa, and face have been reported in the literature.[1],[3],[4] The location on the ear in an immune-competent field, like in our patient, is a very rare finding, and very few cases have been reported in the literature.[5]
Formaldehyde 5% in Flexible Collodion Compared to Cryotherapy for Treatment of Female Genital Warts
Authors: Jahromi Bahia Namavar , Razeghi Mahsa , Dastgheib Ladan , Fazelzadeh Arezou , Miri Amir , Vakili Sina , Foruhari Sedigheh , Sabetian Soudabeh
Published: May 2024

Objectives:

Genital wart is a sexually transmitted disease caused by human papillomavirus (HPV) and is responsible for discomfort, and decreased quality of life and productivity in victims with a high recurrence rate after treatments. This study aimed to compare the efficacy and safety of formaldehyde 5% with cryotherapy for the treatment of female genital warts.

Methods:

Eighty women with at least two similar genital warts who visited the outpatient dermatology clinic of Shahid Faghihi hospital, Shiraz, Iran, were enrolled in this study. One lesion of each patient was self-treated with formaldehyde 5% in flexible collodion gel once daily for 28 days and the other matched lesion was treated by weekly repeated cryotherapy courses. The number of eradicated lesions and the mean days needed to treat, pain scores, complications and patient satisfaction were compared between the treatment methods.

Results:

Complete clearance of lesions was observed in 58.7% of formaldehyde-treated lesions compared to 88.7% for cryotherapy (P value = 0.000). With formaldehyde-treated lesions, 51% complained of pain, 36.3% had pruritus, 86.3% had skin dryness, 88.8% complained of burning sensation and 93.7% showed erythema. In the cryotherapy group, 92.5% complained of pain, 15% had burning sensation, 75% showed erythema, 5% had atrophy, 80% developed post-inflammatory hyper or hypopigmentation (PIH) and 92.5% suffered from ulceration. Seventy-five (93%) found it easy to apply and (47) 58% were satisfied with their treatment results.

Conclusions:

Self-administration of formaldehyde 5% resulted in a lower clearance rate but had better cosmetic outcomes with lower pain scores compared to cryotherapy.
Maskne
Authors: Rathi Sanjay K. , Dsouza Jeanne Maria
Published: May 2024

”Maskne” has been one of the negative spinoffs of the universally acceptable and effective role of face mask in containing the ongoing pandemic of SARS-CoV-2 virus or COVID 19. Several factors contribute to its aetiopathogenesis including heat, humidity, mechanical friction and microbiome dysbiosis in a complex interplay under the occlusive area of the mask. Clinically, the morphology is not very different from acne vulgaris with comedones and inflammatory acne, but in a characteristic distribution over a roughly circular area of face covered by mask. Since the use of face masks is likely to continue in the near future, measures like wearing a comfortably fitting mask of appropriate fabric, using disposable masks, increasing mask-free period when at safer places, avoiding unnecessary use of personal care products over the occluded skin, proper and gentle cleaning of the affected areas, intermittent mopping off of the excessive sebum and sweat and use of specific, topical and systemic therapy could help in its resolution.
Melanogenesis and Hypopigmentation
Authors: Vinardell M. Pilar , Maddaleno Adriana Solange , Mitjans Montserrat
Published: May 2024

Melanocytes are highly specialized dendritic cells that synthesize and store melanin in subcellular organelles called melanosomes, before transfer to keratinocytes. Melanin is a complex pigment that provides colour and photoprotection to the skin, hair and eyes. The process of synthesis of melanin is called melanogenesis and is regulated by various mechanisms and factors such as genetic, environmental and endocrine factors. The knowledge of the pigmentation process is important to understand hypopigmentation disorders such as vitiligo and also to design adequate treatments. In the present work, we review the signalling pathways involved in vitiligo. Finally, current therapies and treatments including topical, oral and phototherapies are discussed and described, emphasizing future therapies based on different pigmentation mechanisms.
The Sexual Behavior and Protective Conduct among University Students in Germany - Chances and Approaches to Tackle Spread of Sexually Transmitted Diseases
Authors: Fuchs Corbinian , Teichert Niklas , Neu Katharina , Clanner-Engelshofen Benjamin , Zippel Stefan , French Lars E. , Reinholz Markus
Published: May 2024

Background:

Current case numbers of sexually transmitted infections (STIs) in Germany are continuously increasing. Young adults aged 19–29 appear to be especially at risk and are therefore the demographic of ever-growing importance for future prevention work.

Objective:

The aim of the survey was to analyze awareness and protective behavior regarding sexually transmitted infections with a major focus on condom-usage by university students in Germany.

Method:

The collection of data was based on the conduction of a cross-sectional survey for students of Ludwig Maximilian University of Munich, the Technical University Munich, and the University of Bavarian Economy. The survey was distributed via the professional online survey tool “Soscy” and was thus performed completely anonymized.

Results:

Within this study, a total of 1,020 questionnaires were collected and consecutively analyzed. In terms of knowledge about human immunodeficiency viruses (HIV), over 96.0% of participants were aware that vaginal intercourse can be a source of transmission for both sex partners and that condom use can be preventive. In contrast, 33.0% were unaware that smear infections constitute a crucial transmission route of human papillomaviruses (HPV). Concerning protective behavior, 25.2% either rarely or did not use a condom in their sexual history, even though 94.6% agreed that condoms protect against STIs.

Conclusion:

This study outlines the importance of education and prevention work that focuses on STIs. Results might reflect effectiveness of previous education efforts made by several prevention campaigns targeting HIV. On the downside, knowledge of other pathogens that establish STIs appears worthy of improvement, especially considering the partially risky sexual behavior observed. Therefore, we see a strong need to reform education, guidance, and prevention strategies in a way that emphasizes not only all pathogens and connected STIs equally, but also a differentiated presentation of sexuality providing appropriate protection strategies for everyone.
Pure Bullous Pyoderma Gangrenosum, a Challenging Clinico-Pathological Diagnosis
Authors: García-Abellás Patricia , Fernández-Guarino Montserrat , Díaz-Guimaraens Borja , Soto-Castillo Juan J. , Torres-Jiménez Javier , Carrillo-Gijón Rosario
Published: May 2024

Pyoderma gangrenosum (PG) is an uncommon, idiopathic, neutrophilic dermatosis characterised by large necrotic ulcers. Occasionally, patients develop atypical presentations, including pustular, bullous, and vegetative lesions. Bullous pyoderma gangrenosum (BPG) is considered an extremely rare form. We describe a case of BPG in a 76-year-old man, with active oncological history, including a recent diagnosis of hairy cell leukemia. Diagnosis of PG was delayed because of atypical clinical presentation that mimicked necrotising fasciitis. The patient was treated with diverse intravenous antibiotics and several surgical procedures. The suspicion of neutrophilic dermatosis arose from the histopathological studies. In the setting of mandatory clinico-pathological correlation, the aim of this report is to point out the morphological characteristics that allow recognition of this uncommon variant of pyoderma gangrenosum.
Assessment of CXCL10 Before and After Narrow Band UVB Phototherapy in Non-Segmental Vitiligo Patients
Authors: Hussein Sherief M. , Sorour Mohammed Abd El Hakim , Samir Mahitab , Abd El Azim Shaimaa Ahmed , Hossain Ahmed
Published: May 2024

Background:

Vitiligo is a common depigmenting skin disorder characterized by white macules and patches accompanied by local melanocyte loss, caused by autoimmune destruction. Vitiligo is classified into two major forms: segmental vitiligo (SV) and non-segmental vitiligo (NSV). It was also found that the IFN-8/CXCL10 axis is functionally required for both progression and maintenance of the disease. Chemokine 10 (CXCL10) is a pro-inflammatory chemokine which was found to be elevated in the serum of vitiligo patients. UVB has been found to be a useful therapy that results in rapid repigmentation in NSV patients.

Objectives:

To evaluate CXCL10 in vitiligo patients before and after narrow band UVB (NB-UVB) phototherapy, which if targeted could provide new insights for therapeutic intervention for vitiligo.

Patients and Methods:

The study included 25 active NSV patients who were able to comply with the study protocol in the Center of Excellence, Dermatology Outpatient Clinic, National Research Center, Egypt (February 2020–2021). All recruited patients were subjected to documentation of complete history. Dermatological assessment of vitiligo lesions, including vitiligo area score index (VASI) score, CXCL10 and extent of the disease were performed. A 3 mm punch biopsy from active vitiligo lesion (site of biopsy) was taken before and after treatment by NB-UVB, and then immunohistochemical staining was performed to evaluate expression of CXCL10.

Results:

After treatment by NB-UVB there was a significant decrease in VASI score, extent of the disease and CXCL10 expression.

Conclusion:

The decrease in CXCL10 levels could be attributed to the effect of NB-UVB which leads to decrease in IFN-γ level, necessary to release CXCL10 through its pathway resulting in repigmentation and decrease in the extent of the disease and VASI scores.
Effectiveness and Safety of Ozone Therapy for Dermatological Disorders
Authors: Machado Andressa Urbano , Contri Renata Vidor
Published: May 2024

Ozone is a strong oxidizing agent, capable of promoting therapeutic effects such as antimicrobial, anti inflammatory, antioxidant and healing activities, with low probability of toxicity when used in a specific dosage range. The aim of this study was to conduct a literature review to assess clinical trials available over the past 10 years regarding the effectiveness and safety of ozone therapy to treat dermatological disorders. The search for bibliographic material was carried out through PubMed, Cochrane Library and Google Scholar electronic databases. The inclusion criteria covered only controlled clinical trials published from 2011 to 2021 and written in English. The 18 selected clinical trials included 1279 patients (ranging from 12 to 400 patients per study), of which 1185 patients were adults and 94 were children. Ozone therapy was evaluated regarding the treatment of diabetic foot ulcers, digital ulcers, chronic venous leg ulcers, atopic dermatitis, skin burns, onychomycosis, tinea pedis, cutaneous leishmaniasis, balanitis xerotica obliterans and multiple common warts. Only three studies, addressing the treatment of cutaneous leishmaniasis, skin ulcers and skin burns, evidenced lack of effectiveness of ozone treatment. Mild adverse effects occurred in three clinical trials, whereas severe side effects occurred in only one clinical trial, regarding skin ulcers. Therefore, ozone therapy may be suggested as an alternative or complementary treatment in some types of dermatological conditions specially affecting refractory patients. Though, a greater number of high-quality clinical trials is needed to clearly establish the safety of ozone therapy in dermatological disorders.
Experience of Rituximab Therapy in Pemphigus
Authors: Verma Ghanshyam , Sharma Aditi , Rattan Renu , Negi Ajeet , Gupta Mudita , Sharma Rajni
Published: May 2024

Background:

Pemphigus is a group of auto-immune blistering disorders, characterised clinically by mucocutaneous blisters and erosions and histopathologically by intra-epidermal acantholysis. It was traditionally associated with high morbidity and mortality. The use of rituximab has brought upon a new dawn in the treatment of pemphigus.

Aim:

A retrospective analysis to ascertain the efficacy, tolerance, adverse effect profile, remission, and relapse with the use of rituximab.

Material and Methods:

A retrospective analysis of all diagnosed pemphigus patients who received rituximab therapy over a period of 3 years was performed. The patient's baseline characteristics, disease duration, clinical presentations, mucosal involvement, disease-severity assessment, and adverse events with rituximab were noted. The outcomes were evaluated based on the definitions of the disease-outcome parameters as early and late endpoints.

Results:

Of the 17 pemphigus patients, there were 14 females (82.4%) and three males (17.6%) with a mean age of 35.9 ± 16.5 years (range: 9–65 years). Pemphigus vulgaris (PV) was the predominant type in 11 (64.7%) patients. After rituximab infusion, the 17 patients attained the end of consolidation phase (ECP) within 15 days to 3 months, and the mean duration was 1.24 months. The complete remission (CR on/off) ranged from 0.5 to 35 months, and the mean duration of remission was 21.7 months. Within a median time of 4.2 months, almost 80% patients achieved CR on therapy. Nine (53%) patients were in CR without any therapy till the end of the study period, and eight (47%) were in remission while on minimal therapy.

Conclusion:

Rituximab is an efficacious therapeutic agent for pemphigus and is better tolerated and safer to all the previous medications used in the treatment.
COVID-19 and Mucormycosis
Authors: Chillana Suchira , Mohit Chilana Kapil Alias
Published: May 2024

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been associated with a wide range of opportunistic bacterial and fungal infections. Recently, several cases of mucormycosis in people with COVID-19 have been increasingly reported worldwide, in particular in India. 1. To study the total prevalence of mucormycosis and other fungal species in patients' samples. 2. To elaborate on the associated underlying risk factors and their presentations with COVID-19. The study was conducted at the Department of Microbiology, Kalpana Chawla Government Medical College from April 2021 to July 2021 during the COVID-19 pandemic. Both outpatient and admitted cases were included in the study suspected of mucormycosis with underlying COVID-19 infection or post-recovery phase. In total, 906 nasal swab samples were collected at the time of the visit from suspected patients and were sent to the microbiology laboratory of our institute for processing. Both microscopic examinations by preparing a wet mount with KOH and lactophenol cotton blue stain and culture using Sabouraud's dextrose agar (SDA) were done. Subsequently, we analyzed the patient's clinical presentations at a hospital, associated comorbidities, site of mucormycosis infection, past history for use of steroids or oxygen therapy, admissions required, and its outcome in patients with COVID-19. In total, 906 nasal swabs from suspected cases of mucormycosis in people with COVID-19 were processed. In all, 451 (49.7%) fungal positivity was seen, out of which 239 (26.37%) were mucormycosis. Other fungi such as Candida (175, 19.3%), Aspergillus 28 (3.1%), Trichosporon (6, 0.66%) and Curvularia (0.11%) were also identified. Out of the total, 52 were mixed infections. The total percentage of patients having underlying active COVID-19 infection or in the post-recovery phase was 62%. Most cases (80%) were of rhino-orbital origin, 12% were Pulmonary and the rest 8% where no primary site of infection was confirmed. Among risk factors, pre-existing diabetes mellitus (DM), or acute hyperglycemia was present in 71% of cases. Corticosteroid intake was recorded in 68% of cases, chronic hepatitis infection in 4%, two cases of chronic kidney disease, and only one case with triple infection of COVID-19, underlying HIV, and pulmonary tuberculosis. Death from fungal infection was reported in 28.7% of the cases. Even with rapid diagnosis, treatment of underlying disease, and aggressive medical and surgical intervention, the management is often not effective, leading to an extension of the infection and ultimately death. So, early diagnosis and prompt management of this suspected new emerging fungal infection with COVID-19 should be considered.
A Clinical Study of Efficacy of Autologous Platelet-Rich Fibrin (PRF) in Chronic Non-Healing Ulcers
Authors: Madhu M , Hulmani Manjunath , Naveen Kumar A C , Kumar V Jagannath
Published: May 2024

Background:

Chronic ulcers are defined as the breakdown of the epidermal and dermal tissue lasting for more than 6 weeks. There will be a lack of necessary growth factors in chronic non-healing ulcers. This study is aimed at accessing the efficacy of autologous platelet-rich fibrin in chronic non-healing ulcers.

Aims and Objectives:

To determine the efficacy of autologous platelet-rich fibrin in chronic non-healing ulcers and to compare the rate of healing in different ulcers based on aetiology.

Methods:

A hospital-based prospective study was conducted at the Department of Dermatology, Venereology, and Leprosy, at a tertiary care centre in Central Karnataka with 50 cases of chronic non-healing ulcers over 2 years. In each case baseline data including age and gender was collected and thorough general physical, local, and systemic examinations were done with the help of a predesigned proforma. PRF dressing was done weekly for 4 weeks with ulcer volume measured each time and improvement accessed.

Results:

In this study, the mean age of the study population was 43.56 ± 14.06 years, with 84% males. Good improvement in the volume of the ulcer was seen in 6 patients out of 50, moderate improvement was seen in 20 out of 50 patients and mild in the rest of the 24 patients. Improvement was more in the educated sector, more so in females and patients with trauma as the cause of ulcers without any comorbidities. Leprosy followed by diabetes was the main cause of chronic non-healing ulcers.

Conclusions:

This study shows that autologous platelet-rich fibrin therapy provides faster wound healing in chronic non-healing ulcers with no adverse events.
Body Mass Index, Disease Duration and Tumor Necrosis Factor Inhibitor History Predict Reduced Ustekinumab Response in Chinese Psoriasis Patients
Authors: Xu Xue , Qin Guifang , Meng Zudong , Pei Dan
Published: May 2024

Background:

Ustekinumab, as a monoclonal antibody against interleukin (IL)-12 and IL-23, gets approved in China since 2019, therefore fewstudies report the application of ustekinumab in treating Chinese psoriasis patients in the real clinical settings until now.

Aims:

Thus, this study aimed to evaluate treatment efficacy, treatment response–related factors, and safety of ustekinumab in treating Chinese psoriasis patients.

Materials and Methods:

Totally, 72 moderate-to-severe plaque psoriasis patients who underwent ustekinumab treatment were analyzed. Their clinical data were recorded. Furthermore, improvement of psoriasis area severity index (PASI) score more than 75% (PASI75) and improvement of PASI score more than 90% (PASI90) at week 12 and week 24 were retrieved. Besides, the adverse events were reviewed.

Results:

There were 72.2% and 37.5% psoriasis patients who achieved PASI75 response and PASI90 response at week 12. Meanwhile, 86.7% and 46.7% psoriasis patients realized PASI75 response and PASI90 response at week 24. Besides, multivariant logistic regression analyses revealed that body mass index (BMI), disease duration, and history of tumor necrosis factor (TNF) inhibitors could independently predict reduced ustekinumab response in psoriasis patients. Additionally, the most common adverse events of ustekinumab treatment in psoriasis patients were infection (12.5%) and nasopharyngitis (9.7%), followed by headache (4.2%), cough (4.2%), abnormal hepatic function (4.2%), injection site reactions (2.8%), and eosinophilia (1.4%), which were all mild and manageable.

Conclusions:

Ustekinumab is an effective and safe immunotherapy drug for treating Chinese psoriasis patients. Furthermore, BMI, disease duration, and history of TNF inhibitors are predictors of poor ustekinumab response.