Efficacy of moisturizers in paediatric atopic dermatitis: A systematic review and meta-analysis of randomised controlled trials

Background: Topical moisturizer is recommended for atopic dermatitis. Aims: The aim of the study was to investigate the knowledge gap regarding the efficacy of moisturizer in young patients. Methods: A systematic review and meta-analysis were conducted on randomised controlled trials comparing participant’s ≤15 years with atopic dermatitis, receiving either topical moisturizer or no moisturizer treatment. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Results: Six trials were included (intervention n= 436; control n= 312). Moisturizer use extended time to flare by 13.52 days (95% confidence interval 0.05–26.99, I2 88%). Greater reduction in risk of relapse was observed during the first month of latency (pooled risk ratio 0.47, 95% confidence interval 0.31–0.72, I2 28%) compared to the second and third months (pooled risk ratio 0.65, 95% confidence interval 0.47–0.91, I2 35% and pooled risk ratio 0.63, 95% confidence interval 0.47–0.83, I2 33%, respectively).Treated patients were 2.68 times more likely to experience a three–six months remission (95% confidence interval1.18–6.09, I2 56%). Moisturizer minimally improved disease severity and quality of life. Limitations: There is a dire need to conduct randomised controlled trials with more robust and standardised designs. Conclusion: Moisturizer benefits young patients with atopic dermatitis. However, more research is needed to better estimate its efficacy. </jats:sec

Nasal carriage and antimicrobial susceptibility of Staphylococcus aureus among medical students at the HRH Princess Maha Chakri Sirindhorn Medical Center, Thailand: A follow-up study

SummaryObjectiveThe objective of this study is to evaluate the patterns of nasal colonization of Staphylococcus aureus and its susceptibility patterns among medical students before and after their rotations in the hospital.MethodsNasal swabs were obtained from 128 medical students for microbiological study and susceptibility testing prior to working in the hospital (the first), following the first rotation (the second) and at the end of the rotation schedule in the hospital (the last). The probable risk factors for nasal carriage were recorded for assessment.ResultsS. aureus was isolated at the first, second and last swabs with colonization rates of 29.7%, 30.5% and 39.4%, respectively. The prevalence rate of colonization of S. aureus showed a statistically significant increase (P<0.05). There was a persistent colonization of S. aureus at the rate of 20.3%. No participants showed methicillin-resistant S. aureus. The susceptibility of S. aureus to erythromycin and clindamycin was 36.8%, 41% and 34% at the first, second and last swabs, respectively. There was no significant correlation between nasal carriage of S. aureus and its potential risk factors.ConclusionsAfter clinical rotation in the hospital, the prevalence rate of asymptomatic nasal carriage of S. aureus increased and the S. aureus isolated has shown a relatively high resistance to erythromycin and clindamycin

Correlation between skin color evaluation by skin color scale chart and narrowband reflectance spectrophotometer

Context: Various methods are available for the evaluation of skin color. A skin color scale chart is a convenient and inexpensive tool. However, the correlation between a skin color scale chart and objective measurement has not been evaluated. Aims: To assess the correlation between skin color evaluation done by a skin color scale chart (Felix von Luschan skin color chart) and a narrowband reflectance spectrophotometer (Mexameter MX18). Materials and Methods: The participants were evaluated for skin color by using the Felix von Luschan skin color chart (range 1-36) and a narrowband reflectance spectrophotometer (Mexameter MX18) in which the results of the measurements were expressed as Erythema (E) and Melanin (M) indices. Skin color was measured on four different anatomical skin sites from each participant on the medial aspect of the volar and the dorsal regions of both forearms. Results: A total of 208 records from 52 participants were established. The majority of participants (19.2%) were rated with the skin color scale at the number 16 (range 14-33). The mean M plus E, M, and E indices were 498.9 ± 143.9, 230.4 ± 74.4, and 268.5 ± 73.2, respectively. The correlation coefficient between the number on the skin color scale and each index: M plus E, M, and E indices were 0.90, 0.90, and 0.86, respectively, with a statistical significance of P < 0.001. Conclusions: Skin color evaluation using a skin color scale chart has shown a high correlation with skin color evaluation done by the narrowband reflectance spectrophotometer

Nasal carriage and antimicrobial susceptibility of Staphylococcus aureus among medical students at the HRH Princess Maha Chakri Sirindhorn Medical Center, Thailand: A cross sectional study

SummaryObjectiveTo determine the epidemiology of the nasal carriage of Staphylococcus aureus and its susceptibility pattern among preclinical medical students at the HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University.MethodsNasal swabs were taken from 128 preclinical medical students prior to working at the hospital. Susceptibility testing of S. aureus was performed using Kirby Bauer's disc diffusion method.ResultsOf the 128 participants, 38/128 (29.7%; 95% confidence interval [CI]=21.8%, 37.6%) were carriers of S. aureus. No methicillin-resistant S. aureus was detected by the cefoxitin disk diffusion test. Resistance of S. aureus to erythromycin, clindamycin, tetracycline, chloramphenicol and fusidic acid was observed at the following rates: 63.2% (95% CI; 47.8%, 78.5%), 63.2% (95% CI; 47.8%, 78.5%), 34.2% (95% CI; 19.1%, 49.3%), 2.6% (95% CI; −2.5%, 7.7%) and 2.6% (95% CI; −2.5%, 7.7%), respectively. There was no statistically significant correlation between nasal carriage of S. aureus and possible risk factors.ConclusionsThe prevalence of asymptomatic nasal carriage of S. aureus was higher than reported by previous literature in Thailand, and S. aureus isolates exhibited relatively high resistance to erythromycin and clindamycin

The efficacy of topical 0.1% adapalene gel for use in the treatment of childhood acanthosis nigricans: A pilot study

Aims: To assess the degree of improvement of neck hyperpigmentation in childhood acanthosis nigricans (AN) after treatment with topical 0.1% adapalene gel and the assessment of localized tissue tolerance to the gel. Subjects and Methods: A split comparison study of the hyperpigmentation on the neck was conducted in patients diagnosed with childhood AN. Patients were treated with topical 0.1% adapalene gel for a period of 4 weeks. The skin color of their neck was evaluated at baseline, 2 weeks and 4 weeks using a skin color chart. Skin color ratio (the skin on their necks compared with the skin on their backs) was calculated for all subjects. The investigator′s global evaluation (IGE) scale and the parent′s global evaluation (PGE) scale were used to assess the efficacy of the patients′ treatment at the end of the 4 th week. Results: The mean skin color ratio of therapeutic side was significantly decreased from the baseline scores, at weeks 2 and 4, respectively (30.1%, 18.3%, and 12.9%, P < 0.001), with marked skin improvement at 60.7% ± 28.5%. The percentage of changes of skin color ratio was consistent with the efficacy evaluations as performed by the IGE and PGE scales. Treatment-related cutaneous irritation was minimal, predominantly in the first 2 weeks of treatment and was shown to be well-tolerated at week 4 following a modification of the treatment regimen. Conclusions: The study has shown the efficacy of topical 0.1% adapalene gel in the treatment of AN, specifically, in regards to the skin darkening with minimal cutaneous irritation

Delayed onset acute hemiparesis in Japanese Encephalitis: A case report and literature review (อาการแขนขาซีกซ้ายอ่อนแรงเฉียบพลันที่เกิดตามหลังโรคไข้สมองอักเสบเจอี: รายงานผู้ป่วย 1 ราย)

Japanese encephalitis remains an important public health burden in Thailand despite japanese encephalitis vaccine has been employed in the Expanded Program of Immunization (EPI). Acute stroke or hemiparesis was an atypical feature in japanese encephalitis. We report a case of japanese encephalitis proven by demonstration of specific IgM antibody against JEV in serum with delayed presentation of left hemiparesis. No remarkably structural abnormality of brain parenchyma was detected by computer tomography (CT) and magnetic resonance imaging (MRI). With supportive treatment and physical rehabilitation, this patient has returned to fully normal neurological function