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Onychomycosis (OM) is the commonest cause of dystrophic nails, responsible for upto 50% of cases. Apart from significantly damaging the nails, quality of life, and self-image of the sufferer, it also acts as a reservoir of fungal infections carrying important implications for emerging recalcitrant dermatophytoses. Treatment of OM is based on guidelines released almost a decade back, in addition to published literature and personal preferences. Hence, an expert group of nail society of India (NSI) worked towards drafting these guidelines aimed at compiling recommendations for pharmacologic treatment of OM, based on scientific evidence, along with practical experience. The group did an extensive analysis of available English language literature on OM published during the period 2014-2022. The evidence compiled was graded and discussed to derive consensus recommendations for practice. Special focus was placed on combination therapies and adjunct therapies, including experience of members, to improve treatment outcomes. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) identified the importance of self-care interventions in achieving Universal Health Coverage in 2019. It urges every country to include self-care interventions in their policies and guidelines. To guide the countries in this process, it released guidelines in 2019 and revised them in 2022. However, implementation of new interventions is not a path free of thorns. These guidelines have their own set of strengths and limitations that will differ from country to country. [ABSTRACT FROM AUTHOR]

Background: The study was conducted to compare and evaluate the disinfecting efficacy of four different herbal oils with standard autoclaving against Enterococcus faecalis (E. faecalis). Fifty round burs were infected with E. faecalis and dipped into the chemical test solution for 10 min. The disinfecting efficacy for each test chemical was checked using culture method on blood agar plate and peptone water test to check for turbidity. Clove leaf oil and Tulsi leaf oil have very good antimicrobial efficacy against E. faecalis which are similar and comparable to that of autoclaving. Aim: This stusy aimed to compare the efficacy of pomegranate peel extract (PPE) oil, Garlic oil, Tulsi leaf oil, and Clove leaf oil with standard autoclaving on dental round burs tested against E. faecalis. Settings and Design: The disinfecting capability of four different experimental oils against autoclave was evaluated on 50 round burs exposed to E faecalis in an In-vitro study. Materials and Methods: A total of 50 round dental burs were exposed to E. faecalis and the disinfecting capability of four different experimental oils against autoclave was evaluated by counting colony-forming units (CFUs) and turbidity test. Statistical Analysis: Statistical analysis was performed using SPSS version 20.0 (IBM), Chicago. The CFUs between the five groups (I, II, III, IV, V) were compared using the Chi-square test. The level of significance was kept at 5%. Results: Clove leaf oil showed the best disinfection efficacy comparable to autoclaving, followed by Tulsi leaf oil with no statistically significant difference between them, whereas garlic oil and PPE oil were significantly less effective against E. faecalis. Conclusion: Clove leaf oil and Tulsi leaf oil can be used for disinfecting dental burs, infected with E. faecalis, as alternatives to autoclaving. [ABSTRACT FROM AUTHOR]

Central venous stenosis (CVS) refers to a significant stenosis of a large intrathoracic vein, such as the subclavian, brachiocephalic, or the superior vena cava (hemodialysis, HD). Percutaneous transluminal angioplasty (PTA) with or without stent placement has been the recommended as the preferred approach to CVS. A total of 10 consecutive HD patients with documented CVS over a 2-year time period from April 2017-April 2019 underwent percutaneous angioplasty and stent insertions under sedation. The procedure was performed by the interventional cardiologist in the institute. One patient underwent only PTA, whereas nine (90%) had PTA with primary stent insertion. Primary patency was 90% at 3 months, 80% at 6 months while at 12 months, it was 70% and remained at 70% at 24 months. We did not find any association between age, gender, diabetic status, dialysis vintage, or previous catheter infection with procedural patency. Central venous stenosis can be treated successfully with percutaneous angioplasty and primary stenting. Despite advances, prevention of CVS should be the primary approach. [ABSTRACT FROM AUTHOR]

The article describes the case of a 6-year-old female child who was evaluated due to recurrent episodes of fever, arthralgia and asymptomatic skin lesions for three years. Examination revealed multiple firm erythematous plaques and nodules with central ulceration and crusting with atrophic scars present on the extremities. Evidences from clinical, laboratory and histopathological examinations led to a diagnosis of erythema elevatum diutinum.

Renal failure is a potent risk factor for stroke, which is a leading cause of morbidity and mortality worldwide. The risk of stroke is 5-30 times higher in patients with chronic kidney disease (CKD), especially on dialysis. Case fatality rates are also higher reaching almost 90%. It is therefore important to understand the factors that predispose to stroke in this vulnerable population to better apply preventive strategies. The heightened risk of stroke in CKD represents the interplay of the vascular co-morbidities that occur with renal impairment and factors specific to renal failure such as malnutrition-inflammation-atherosclerosis complex, the effect of uremic toxins, dialysis techniques, vascular access, and the use of anticoagulants to maintain flow in the extracorporeal circuit. Old age, hypertension, diabetes, and previous cerebrovascular disease are all risk factors for stroke with the period of dialysis initiation constituting the highest risk period for developing new stroke. Patients with CKD-stage 3-5 have worse survival and diminished functional outcomes following stroke. Thrombolytic therapy for stroke in CKD has shown an increased risk of symptomatic intracranial hemorrhage or serious systemic hemorrhage, and the therapeutic effects may be attenuated. Benefit of statin therapy in dialysis patient as preventive therapy has not been shown to be beneficial. Control of hypertension and the judicious use of antiplatelet agents form the mainstay of stroke prevention. The benefit of antiplatelet therapies and oral anticoagulants has to be balanced against the real and increased risk of bleeding that is most evident in dialysis cohorts. An increased risk of vascular calcification particularly intracerebral vascular calcification has been seen in patients-receiving warfarin as prophylaxis in atrial fibrillation. Newer anticoagulants have not been tested in patients with glomerular filtration rate <30 ml/min and hence have to be used with caution. This article is a review of stroke in patients with CKD and approach to managing it. [ABSTRACT FROM AUTHOR]

A 23-year-old lady presented with a slowly progressing firm mass on the nasal dorsum since 8 months. Her biochemical, haematological and collagen vascular disease screening tests were normal. Radiographs of the nasal bones showed a subcutaneous calcifying lesion with no evidence of nasal bone erosion. A diagnosis of idiopathic calcinosis cutis (ICC) was made. The mass was excised and soft tissue defect was augmented with silicone prosthesis. The histopathology with the haematoxylin and eosin staining and von Kossa stain confirmed the diagnosis of calcinosis cutis. This is an unusual presentation of ICC involving the nasal dorsum requiring surgery and nasal dorsal augmentation with silicone prosthesis. [ABSTRACT FROM AUTHOR]

A 55-year-old male presented with asymptomatic extensive skin lesions since one year. He was found to have diffuse lesions involving the face, trunk, arms, and thighs along with symmetric peripheral nerve thickening. Bacteriological and histopathological examination confirmed lepromatous leprosy. There was a conspicuous sparing of the abdominal creases and axillae from the infiltrative lesions suggesting a positive "deck-chair" sign. This sign has been described in the past with papulo-erythroderma of Ofuji and certain other disorders. Leprosy may be now included among the causes of "deck-chair" sign. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 18-year-old male patient who presented with Grade 2 acne vulgaris. He undergone glycolic acid peel and developed contact urticaria (CU) as an adverse reaction to treatment. He was given hydroxyzine hydrochloride 25 milligram tablet and pruritus subsided over a period of 2 hours. The article discusses CU, an unusual adverse reaction to glycolic acid peel.

A 22-year-old male presented with fullness in the lateral aspect of the right upper lid and swelling in right lateral canthal area since 6 years. The swelling has progressed minimally since then. He did not seek any medical treatment partly because the swelling was not grossly visible from outside, and partly he did not have any pain. There was no history of trauma. On examination an 8 mm + 4 mm translucent bluish-purple nodular soft cystic swelling with a hyperemic swollen conjunctival base was found in the palpebral portion of the lacrimal gland [Figure 1]. He had two transparent cysts in the palpebral portion of the lacrimal gland in the left eye as well. These were nontender with no associated involvement of adjacent structures or signs of inflammation. There was no preauricular or submandibular lymphadenopathy. Slit lamp examination both eyes showed normal anterior (cornea, anterior chamber, lens) and posterior segments. [ABSTRACT FROM AUTHOR]