Laser Carbon Peel: New Armamentarium for Inflammatory Acne.

There is an increasing interest in procedures to improve skin quality in acne patients with a short downtime. Off late, carbon peel laser technique which uses topical carbon suspension combined with Q-switched Nd:YAG laser treatment has gained popularity. The main advantages of this procedure are easy to perform and it requires less than 30 minutes.

Insights in tuberculosis immunology: Role of NKT and T regulatory cells.

Background: Tuberculosis (TB) control is challenging due to poor drug compliance and emerging resistance. The need of the hour is to determine the prediction of disease cure and relapse. Patients' immune response is crucial to the disease outcome. This study was designed to study the immune profile of TB patients during treatment and cure. Methods: The cross-sectional study included newly diagnosed pulmonary TB patients and healthy controls. Levels of serum cytokines/chemokines (Th1/Th2/Th17) were measured by BD cytometric bead array. The cell surface markers assessed in the study were CD3, CD4, CD8, CD16, CD56, and BD human regulatory T cell cocktail (CD4/CD25/CD127). Results: Data analysis observed statistically significant differences in CD3dim/CD56 + natural killer T (NKT) among TB patients with significantly low levels in healthy controls and after treatment completion (P < 0.0001). The analysis also revealed a high percentage of CD3dim/CD56 + NKT in fast responders. The percentage of T regulatory was found to be high in patients when compared with healthy controls; the values were statistically significant (0.0002). Interleukin-6 was significantly associated with the disease (P < 0.0485). Discussion: A comprehensive understanding of role of CD3dim/CD56+ NKT in antimycobacterial immunity may enable new possibilities for NK cell-based prophylactic and/or therapeutic strategies against TB.

Pleural Aspergillosis in an otherwise healthy individual.

Pleural Aspergillosis is a rare entity, with most of the cases occurring on a background of lung disease or surgery. We report a case of a 16-year-old boy who developed pleural Aspergillosis in the absence of any obvious pre-disposing factors. Patient presented with fever, dry cough and left sided chest discomfort of 6 weeks duration. A chest radiograph revealed features of the left pyopneumothorax. Despite being started on presumptive antituberculous treatment and intercostal drainage his symptoms failed to resolve. The sputum and pus were then subjected to fungal smears and culture, which indicated growth of Aspergillus fumigatus. We report this case in view of the extreme rarity of pleural Aspergillosis occurring in a young healthy individual with no evidence of prior lung pathology. Furthermore, the source of infection was traced back to a very unusual possible focus - a decayed tooth infected with A. fumigatus, thus making the case even more interesting.

Initiation of MDR TB treatment: is hospitalization worth?

BACKGROUND: The treatment for MDR TB is quite prolonged and associated with adverse effects and hence costly. AIM: The aim of study was to study the side-effects of reserve line drugs developing in initial seven days of starting therapy, so as to weigh the need for admission for initiation of treatment against heavy economic burden by admission of huge number of MDR TB patients, and to identify the factors which may have an effect on the number of patients developing side-effects METHODS: All MDR TB patients (930) admitted during study period, who were initiated on Cat IV treatment for MDR TB under RNTCP were questioned daily for any side-effects throughout the day, during initial seven days of treatment. RESULTS: On day one, 342 (36.8%) patients developed side-effects, on 2nd day 456 (49%), on day 3 356 (38.3 %), on fourth day 257 (27.6%), then on fifth day only 172 (18.5 %) patients respectively had reported side-effects. Further decline of side-effects was reported on sixth day 94(10.1%) and seventh day 39(4.2%). Number of events also decreased from 669 on dayl and 965 on day 2, to only 61 on day 7 of treatment. Most of the patients had nausea, vomiting, pain abdomen, restlessness, dizziness, insomnia and headache. Patients with low Hemoglobin had more side-effects from day 2 onwards (p<0.05).Age, BMI, gender and co-morbidities had no significant effect on side-effects in these patients. CONCLUSION: Many patients report side-effects initially on treatment, which gradually decrease from day 4 onwards , so hospitalization for atleast seven days during initiation of Cat IV may not be required in all the patients.