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A current shortage of pediatric dermatologists limits access to dermatologic care among the pediatric population, yet comprehensive and updated data are lacking regarding access among the pediatric Medicaid population. This cross‐sectional study characterized Medicaid acceptance among actively practicing board‐certified pediatric dermatologists in the United States and revealed that of the 352 physicians compiled, 275 (78.1%) accept Medicaid. Significant differences in Medicaid acceptance status were observed based on practice type, region of practice, practice county median household income, and density of pediatric dermatologists. While the majority of practicing board‐certified pediatric dermatologists accept Medicaid, our findings suggest that differences in access to Medicaid‐accepting pediatric dermatologists exist based on practice type, geographic location, and density of pediatric dermatologists per county. [ABSTRACT FROM AUTHOR]

Aim: To analyze the potential predisposing factors and clinical presentation of mucormycosis in patients with COVID-19. Material and Methods: Medical records of 141 patients with COVID-19-associated mucormycosis (CAM) treated at a tertiary care center in Bihar were reviewed. The predisposing factors, clinical features, and imaging findings of mucormycosis were analyzed. Results: The median age was 48 years (IQR, 43-60). A total of 58 patients developed concurrent CAM and 83 post-CAM. The median interval between COVID-19 and onset of CAM symptoms was 15 days (IQR, 9--16). A total of 80 patients received at-home treatment for COVID-19, and 73 had mild-to-moderate disease. While 61 patients received in-hospital treatment, 57 had severe disease. At presentation, 131 patients had hyperglycemia: 64 type 2 diabetes mellitus (DM) and 67 new-onset DM. The history of glucocorticoid use for COVID-19 was present in 125 patients; 47% were administered at home without monitoring plasma glucose. The common presenting features were toothache, periocular or facial pain, and edema. Rhino-orbital mucormycosis was the most common. Imaging revealed rhinosinusitis in all patients, including pansinusitis (68%), pterygopalatine fossa involvement (21%), cavernous sinus thrombosis (38%), brain abscess (8%), and infarct (4%). All patients received intravenous liposomal amphotericin B, and surgical debridement was performed in 113. Conclusion: COVID-19 patients with hyperglycemia are at risk of developing CAM, irrespective of the severity. Timely recognition of symptoms and prompt initiation of therapy by primary healthcare physicians are imperative for enhancing outcomes. Additionally, glucocorticoid overuse should be avoided, and close monitoring for hyperglycemia development is warranted. [ABSTRACT FROM AUTHOR]

Background and Objectives: Surgical Site Infections (SSI) are prevalent complications following surgical procedures globally. However, there is a relative scarcity of published data on SSI patterns in developing countries like India. This study aims to assess the incidence, risk factors, and antibiotic profiles of SSI pathogens, addressing this research gap. Materials & methods: In this retrospective study, a total of 441 patients who were admitted to the surgical department of a tertiary care teaching hospital in Central India from January 2016 to December 2016 were included. Patient data was gathered from hospital records using a structured data collection form. Statistical analysis was performed using SPSS software version 20.0, with a P-value of less than 0.05 indicating statistical significance. Results: The incidence of SSI in our study was 11.11 %, with associated risk factors including age, ASA class, surgeon's expertise, wound classification, prolonged surgery duration (>2 h), extended hospital stay, transfusion, and emergency surgical procedure. Klebsiella spp, Escherichia coli, Proteus spp, Acinetobacter, Staphylococcus aureus, and coagulase-negative staphylococci were the isolated pathogens, exhibiting varying levels of antibiotic resistance. Amikacin and Imipenem showed almost 100% sensitivity against all pathogens Conclusion: The incidence rate SSI fell within standard international ranges. However, approximately 50% of the isolates exhibited multi-drug resistance, limiting treatment options for patients with SSI. To address this, regular surveillance of pathogens and antibiotic susceptibility, alongside the strict implementation of protocols for antibiotic administration and operating room regulations, becomes crucial in mitigating the impact of SSI caused by drug-resistant bacterial pathogens. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose was to study the anatomical and functional outcome following single low-dose suprachoroidal triamcinolone acetonide (LD-SCTA) (2 mg) injection in noninfectious posterior uveitis. METHODS: Eleven patients with macular edema (ME) more than 280 μ secondary to noninfectious uveitis were included in the study. A single LD-SCTA (0.5 ml) injection was performed in the study eye with the help of a novel suprachoroidal microneedle (Pricon, Iscon Surgicals, Jodhpur, Rajasthan, India). The study parameters were noted at 4 and 12 weeks post LD-SCTA injection. RESULTS: Ten of 11 patients had a significant decrease in central macular thickness (CMT). The mean CMT measurement at baseline was 513.6 ± 191.73 μm for the 10 patients who responded to the treatment, which reduced significantly to 265.1 ± 34.72 μm (P < 0.003) and 260.6 ± 34.72 μm (P < 0.002) at 4 and 12 weeks, respectively. The mean best-corrected visual acuity (BCVA) at baseline was 0.84 ± 0.41 logMAR unit which improved to 0.52 ± 0.33 (P < 0.001) and 0.25 ± 0.22 (P < 0.000) at weeks 4 and 12, respectively. The mean intraocular pressure at baseline recorded was 16.36 ± 2.97 mmHg, 19.45 ± 4.80 mmHg (P = 0.06) at 4 weeks, and 17.27 ± 2.53 mmHg (P = 0.35) at 12 weeks. One eye which did not respond to LD-SCTA was a case of recurrent Vogt–Koyanagi–Harada disease. CONCLUSION: Single LD-SCTA injection is efficacious in reducing CMT in ME, improving BCVA, and controlling the inflammation in noninfectious posterior uveitis. LD-SCTA can be used as a first-line therapy in noninfectious uveitis over other routes of steroid administration with a favorable outcome and safety profile. [ABSTRACT FROM AUTHOR]