Noma in the WHO's list of neglected tropical diseases: A review of its impact on undeveloped and developing tropical regions.

Background: Noma is a neglected tropical disease and a global health concern. Objectives: To elucidate the epidemiology, management, prevention, and public health implications of Noma. Methods: PubMed, Scopus, and Web of Science, supplemented by Google Scholar and World Health Organization databases, were searched using keywords to gather both published and grey literature from 1970 to 2023 in English. Results: Approximately 30,000-40,000 cases occur annually, with varying incidences across various African countries, such as Nigeria, Niger, and Chad. Incidence in Nigerian and Ethiopian states range from 0.6 to 3300 and 1.64 to 13.4 per 100,000 population, respectively. Mortality is approximately 8.5% in Niger. Risk factors include malnutrition, immunocompromised status, poor dental hygiene, inadequate sanitation, gingival lesions, low socioeconomic status, chronic and infectious diseases, low birth weight, high parity, diarrhoea, and fever. Diagnosis is primarily made based on clinical signs/symptoms and accordingly staging of disease is done. Stage I, II and II presents with acute necrotizing gingivitis, facial edema with halitosis, and necrotizing stomatitis, respectively. If the patient survives acute stages, the progress to Stage IV and Stage V manifests as trismus, difficulty in deglutition and phonation, and facial disfigurement, with increased severity in last stage. Treatment encompasses antibiotic therapy (amoxicillin, metronidazole, chlorhexidine, ampicillin, gentamicin), surgical interventions, wound management (honey dressing, ketamine), and nutritional support. Prevention strategies include oral hygiene, vaccination, health education, and community-based interventions. Conclusion: Noma's recent inclusion in WHO list of neglected tropical diseases is a milestone in recognizing the importance of prevention and early intervention to globally enhance health outcomes.

Comparison of intravenous ibuprofen and paracetamol for peri-operative analgesia in paediatric day care tonsillectomy.

OBJECTIVE: To determine the effectiveness of intravenous ibuprofen and acetaminophen as perioperative analgesics in paediatric patients undergoing day- care tonsillectomy with general anaesthesia. METHODS: The quasi-experimental stud y was conduc ted at the Ana esthe sia D epartment of Pa k Emirates M ilitary Hospital, Rawalpindi , Pak ist an, from July 20 21 to June 2022, and comp rised paediatric pa t ients aged 5-12 yea r s undergoing day- care tonsil lec tomy with gen era l anaesthesia. The sub jec ts were divid ed into two equa l groups. Patients in Group I received intravenous ibuprofen 7mg/kg and patients in Group P received intravenous paracetamol 10mg/kg im media t ely after induction of anaesthesi a. All patients recei ved standard general anaesthesia with endotracheal intubation. The primary outcome measured was revised faces pain score immediately after recovery and at the time of discharge 6 hours later. Adverse events were also noted. Data was analysed using SPSS 26. RESULTS: Of the 100 patients, there were 50(50%) in Group I; 21(42%) boys and 29(58%) girls with mean age 7.82±1.903 years. The remaining 50(50%) subjects were in Group P; 25(50%) boys and 25(50%) girls with mean age 7.68±1.812 years. At baseline, 44(88%) patients in Group I and 42(84%) in Group P reported no pain, while 6(12%) and 8(16%) patients in the two groups, respectively, reported pain (p=0.56). At discharge, 35(70%) patients in Group I and 18(36%) in Group P reported no pain (p<0.001). Adverse events were not significantly different between the groups (p>0.05). CONCLUSIONS: I ntravenous ibuprofen was found to b e a superior pain-killer than intravenous paracetamol for perioperative care of paediatric patients in day- care tonsillectomy.

Management of calcified right atrial myxoma extending into the inferior vena cava: a case report.

Cardiac myxomas can rarely involve the right atrium, get calcified and involve the inferior vena cava (IVC). Early surgical intervention is critical to prevent life-threatening complications. We presented the case of a 39-year-old male with fever, cough and shortness of breath for 1 week. Initial laboratory investigations revealed leucocytosis and thrombocytopenia. His electrocardiogram was normal, and his chest X-ray showed bilateral infiltrates. Based on the findings of a high-resolution chest computed tomography scan, echocardiography and cardiac magnetic resonance imaging, we made a provisional diagnosis of calcified right atrial myxoma extending up to the IVC. We managed the case with cardiopulmonary bypass via aortic cannulation followed by a right atriotomy. Post-operatively, the patient's condition improved and was doing well on monthly follow-ups.

Monkeypox outbreak amidst COVID-19 reemergence in the European Region: Challenges, efforts, and recommendations.

Monkeypox (MPX), caused by the Monkeypox virus (MPXV), is an endemic disease in African countries and is currently causing outbreaks in several European regions, amidst a recent surge in new COVID-19 cases. This can significantly impact already exhausted healthcare services, adding on to the economic and social burdens in the region. A lack of sufficient laboratory diagnostics, antivirals, vaccines may hinder effective clinical management of affected patients. Therefore, it is essential to increase awareness about MPX and its transmission among the general population, to ensure necessary precautions are taken and new cases are reported swiftly. This article discusses the impact of MPXV on the current reemergence of COVID-19 in Europe, lessons learnt during the COVID-19 pandemic and recommendations to address potential challenges.

Antimicrobial strategies for scaffolds aided periodontal regeneration - road so far. A systematic review.

OBJECTIVE: To give a comprehensive understanding of the efficacy of antimicrobial-loaded scaffolds as drug delivery system for periodontal regeneration, and to review the recent advances in the field of periodontal regeneration. METHODS: The literature was reviewed using key words "antimicrobial releasing periodontal scaffolds" on Science Direct, PubMed and Web of Science search engines. Shortlisted articles were evaluated on the basis of specific inclusion-exclusion criteria. RESULTS: Of the 544 studies found, 34(6.25%) met the inclusion criteria. The trend indicated an increase in use of antimicrobial-loaded scaffolds that caused inhibition of periodontal pathogenic bacteria, accompanied with greater cellular interaction, and differentiation for alveolar bone healing. Contemporary treatment tactics clinically prove the ability to limit disease progression, but complete periodontal regeneration needs to be validated yet. CONCLUSIONS: Emerging trends are not only improving the inhibitory effect of bacterial growth, but are also making a favourable environment for cell proliferation and differentiation, resulting in alveolar bone repair and re-growth.

Quality Of Educational Environment At Wah Medical College: Assessment By Using Dundee Ready Educational Environment Measure.

BACKGROUND: Educational environment not only has an impact on the students during the academic years but has its reflections throughout their medical career. The Dundee Ready Educational Environment Measure (DREEM) is an internationally accepted useful tool to analyse undergraduate educational environments in the health professionals. The purpose of this study was to assess how students, across all the five years in a private medical college, perceive their educational environment. METHODS: It was a cross sectional study, which used the DREEM inventory at Wah Medical College over the course of 6 months (January-June 2015). All 500 students were included in the study. The fifty items DREEM inventory, having the maximum score of two hundred indicating ideal educational environment was used for data collection. RESULTS: The questionnaire was completed by 400 undergraduate medical students (response rate 80%). The overall DREEM score was 122.63/200 (61.3%), indicating that the perception of the learning environment was more positive than negative. Among the highest scoring categories were students' participation in classes, relaxed atmosphere and confidence in passing the annual exams. However, many areas requiring improvement were also brought to attention. CONCLUSIONS: Overall, the student's perception of their learning environment at Wah Medical College was found to be positive. This study did bring to light some areas that could be improved upon. This should enable the faculty to adopt changes in their teaching methods to make the learning process more productive and enjoyable for future students.