Background  Dermatophytes are fungi parasitizing structures rich in keratin such as skin, hair, and nail, which leads to a dermal inflammatory response with intense itching and cosmetic disfigurement. The climatic condition of eastern India is predominantly hot and humid with severe rainfalls promoting fungal infection. This study was performed to determine the prevalence of dermatophytosis and to isolate and identify the dermatophyte from clinically suspected cases attending tertiary care center. Methodology  This study was conducted from April 2018 to March 2019 and a total of 1,200 samples were included. Skin scrapings were collected and examined microscopically using 10% potassium hydroxide (KOH) mount. Culture was performed using Sabouraud dextrose agar and dermatophyte test medium. Speciation was done based on macroscopic and microscopic findings using lactophenol cotton blue staining and some special tests like urease test and slide culture. Results  Of 1,200 cases, tinea corporis was the most common clinical presentation. Direct KOH positivity was 89.4% and culture positivity was 61.75%. Trichophyton mentagrophyte (77.5%) was the most common dermatophyte isolated followed by Trichophyton rubrum (13.3%). Conclusion  Dermatophytic infections are not serious but their propensity to persist leading to chronicity and disfigurement may have personal and social implications.Background  Bloodstream infections (BSIs) are one of the frequent nosocomial infections among hospitalized patients. To understand the local epidemiology and evolving antimicrobial drug resistance of blood-borne pathogens, we analyzed the distribution and antibiotic sensitivity profile of organisms causing BSI in our hospital-based study.  https://www.selleckchem.com/products/edralbrutinib.html  Materials and Methods  We reviewed retrospective data of laboratory-confirmed BSIs, from January 2013 to December 2018. Causative organisms and their antibiotic susceptibility profile of primary and secondary BSI reports were determined from BacT/Alert and Vitek systems findings (bioMérieux). A 6-year multidrug resistance indexing was done to document the resistance pattern of the commonly isolated organisms. Results  A total of 1,340 (10.2%) BSIs were reported from 13,091 blood cultures. Organisms were frequently isolated from the younger population (≤20 years), especially from ages less then 1 year (20.8% of total BSIs). Majority of pathogens were bacterial (97.1%) whereas 2.9% were fungal in origin. Monomicrobial growth was recorded in over 98% of BSIs. Gram-positive and gram-negative bacteria isolated were 518 (39.8%) and 783 (60.2%), respectively. Commonly isolated organisms were coagulase-negative Staphylococci (29.4%), Escherichia coli (19.8%), Klebsiella species (13.5%), Salmonella species (9.4%), and Staphylococcus aureus (7.5%). Multidrug-resistance index was observed highest in Acinetobacter species followed by Pseudomonas aeruginosa and S. aureus . Conclusion  Overall, there has been a gradual decline in the reporting of BSI. However, infections by gram-negative bacilli and multidrug-resistant organisms remain persistently high. Ages less then 20 years were the vulnerable group, with infants less then 1 year contributing to the maximum number of BSI cases caused by both bacteria and fungi. Therefore, additional methods are required to study the origin and causation of these infections, particularly among vulnerable patients.A middle-aged homeless man presented with ongoing left-hand pain and worsening cutaneous phalangeal color changes. On examination, digital ischemia was observed with associated dry gangrene. Doppler examination showed impaired distal arterial flow. Angiography showed irregular digital perfusion. The patient later provided vital information to secure the diagnosis without further clinical workup. This quiz discusses the presentation, differential diagnosis, and treatment of a rare clinical scenario.The goals of lip reduction surgery are to reduce the volume of the lips and restore an aesthetic labial contour and to maintain an ideal volume relationship between upper and lower lips. The aim of this study was to minimize the excessive large lips by modifying the incision and to get more Indian appearance of the lips by using crab claw technique. A total of nine patients (six males and three females) of age-group 21-22 years, having aesthetic concern due to excessive large lips, were treated in the case series. The distance from the vermilion border to the lip line was recorded at midline and 6-7 mm apart from the either side, and the distance between two peaks corresponding to the philtral ridges at baseline and at 6 months follow-up. A mean reduction of approximately 10 ± 0.70 mm at midline, 10.11 ± 1.05 mm on the right side, and 9.55 ± 0.72 mm on the left side of the lip was obtained in all the nine cases. No postoperative complication was observed in any of the patients, and all the patients were satisfied with the result, which was carried out through a survey completed by all the patients. The lip reduction surgery using crab claw technique proved to be successful in achieving decreased lip volume while restoring anatomical morphometric pattern of lip to look more Indian way.The forehead skin closely resembles the texture and color of the midface region. As such, the use of a paramedian forehead flap to repair a midface defect provides optimal cosmesis; however, the donor forehead site may be left with an undesirable scar in a highly visible region of the face. Cutaneous surgeons possess a variety of traditional techniques intended to minimize scarring. We have found that the addition of 50 units of botulinum toxin at the time of wound closure has improved scar outcomes for patients undergoing reconstruction with paramedian interpolated flaps. Possible mechanisms for the efficacy of botulinum toxin lie in its ability to chemically paralyze the frontalis muscle and glabella complex. This immobilization leads to a reduction in unwanted wound tension during the most vulnerable first few days of healing.Hair transplant is becoming the most common cosmetic procedure across the world with demand for higher density and coverage of baldness. This needs more number of donor hair follicles. Scalp donor has limitations to fulfill the required number of follicles for Norwood Grade VI and VII baldness. The body hair follicles can be used to cover up the deficit.The objective of this study was to observe the use of body hair follicles to increase the visual density and for better coverage for higher grades of baldness as an adjuvant to scalp hair follicles.
  A total of 16 patients were evaluated for the availability of body donor hair, and consent for body hair harvesting was obtained from them. The beard was the first preference and then chest and abdomen hair follicles were used in combination with scalp hair follicles to cover bald area of Norwood grade IV and above baldness. Body hairs were harvested using follicular unit extraction (FUE) technique. Postoperative pictures were taken, and patient satisfaction, doctor's observation, and global photographic evaluation was carried out.