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Background: Chronic spontaneous urticaria (CSU) refers to urticaria that has no specific cause or trigger, present on most days of the week for 6 weeks or more. The incidence of chronic urticaria in the pediatric age group is between 0.1% and 3%. Levocetirizine and bilastine are nonsedative second-generation antihistamines used to treat urticaria in both adults and children. Objective: The primary objective was to compare the effectiveness of levocetirizine and bilastine in cases of pediatric CSU using Urticaria Activity Score (UAS) and Urticaria Severity Score (USS). The secondary objective was to evaluate and compare the safety and quality of life (QoL) using the Dermatology Life Quality Index (DLQI) score. Materials and Methods: This was a randomized, observer-blinded study where 65 patients (6–16 years) with a history of urticaria >6 weeks were divided into two groups with computer-generated randomization. Thirty-two patients were included in Group A, who received levocetirizine, and 33 patients were included in Group B, who received bilastine. UAS7, USS, and DLQI were recorded at every visit. The primary outcome was measured using UAS and USS and the secondary outcome in the form of patient's QoL was assessed using the DLQI score. Laboratory parameters were assessed at the first visit and at the end of 3 months. Results: There was a significant difference (P = 0.002) in UAS7, USS, and DLQI between the baseline and last visit scores for each group. There was no significant difference (P = 0.28) in the scores between the two groups. Laboratory parameters like liver enzymes and complete blood count also did not show any significant differences between the two groups. Conclusion: Both levocetirizine and bilastine are equally effective and safe in the treatment of CSU at the end of 3 months. However, bilastine showed a better fall in the DLQI as compared to levocetirizine. [ABSTRACT FROM AUTHOR]

Aim: This study of our study was to evaluate the onset and duration of sensory and motor block and side effects of clonidine or dexmedetomidine when used as an adjuvant in epidural anaesthesia in total knee replacement. Materials and methods: 60 patients of ASA status I and II, posted for total knee replacement were randomly allocated into two groups of 30 each. Group BC group patients received 18 ml of 0.5% bupivacaine and clonidine 2mcg/kg. Group BD group patients received 18 ml of 0.5% bupivacaine and dexmedetomidine 1.5mcg/kg. Preoperative and postoperative block characteristics as well as hemodynamic parameters were observed and recorded. Results: Dexmedetomidine resulted earlier onset and longer duration of sensory and motor block on comparison to clonidine as adjuvant in epidural anesthesia. Sedation scores were statistically significant with dexmedetomidine group in comparison to clonidine group. Conclusion: Dexmedetomidine was a better than clonidine as an adjuvant to bupivacaine in epidural anaesthesia in total knee replacement. [ABSTRACT FROM AUTHOR]

Background and aim: Many adjuvants have been used with local anesthetics in spinal anesthesia but none has been found ideal. We have conducted this prospective randomized double blind study to evaluate the effect of intrathecal dexmedetomidine when added to ropivacaine in spinal anesthesia. Methods: 50 patients who underwent lower limb surgeries under spinal anesthesia were included in this study and were randomly allocated in to two groups. Group C received intrathecal 3 ml of 0.75% ropivacaine + 0.5 ml normal saline and group D received intrathecal 3 ml of 0.75% ropivacaine + 5 μg dexmedetomidine in 0.5 ml of normal saline. Following intrathecal administration, onset of sensory and motor blockade, maximum dermatomal level achieved, duration of analgesia, hemodynamic parameters and incidence of side effects were observed. Results: Onset of sensory and motor block was earlier in group D compared to group C which was statistically significant. Block regression was significantly delayed with the addition of intrathecal dexmedetomidine (Group D) as compared to ropivacaine alone (Group C). Both, time to two segment regressions and time to regression to S2 were delayed significantly in group D. The duration of analgesia was also significantly prolonged in group D (348.00±23.02 min) as compared to group C.(207.60±17.23min) There were no significant difference in haemodynamic parameters and incidence of side effects in both the groups. Conclusion: The addition of dexmedetomidine(5 μg) to ropivacaine in spinal anesthesia produces significantly longer sensory and motor blockade along with prolonged postoperative analgesia, without any significant side effects. [ABSTRACT FROM AUTHOR]

This article, titled "Hyper-IgE Syndrome Presenting as Abnormal Dentition and Coarse Facies," discusses a case of Hyper-IgE syndrome, also known as Job syndrome. The syndrome is a primary immunodeficiency characterized by recurrent infections, distinctive facial characteristics, and eczema. The article describes the case of a 14-year-old girl who presented with facial coarseness, abnormal dentition, and skin eruptions. The patient was treated with antibiotics and isotretinoin, which resulted in significant improvement. The article emphasizes the importance of recognizing the facial characteristics and skin eruptions associated with Hyper-IgE syndrome for early diagnosis and prevention of complications. [Extracted from the article]

Bedside test, fungal culture, fungal infection, KOH mount, mucormycosis, Rhizopus Keywords: bedside test; fungal culture; fungal infection; KOH mount; mucormycosis; Rhizopus EN bedside test fungal culture fungal infection KOH mount mucormycosis Rhizopus 3619 3621 3 08/09/22 20220801 NES 220801 ACKNOWLEDGEMENT None. [Extracted from the article]