In August 2021, the Marburg virus disease (MVD) outbreak was confirmed amid the coronavirus disease 2019 (COVID-19) pandemic in the Republic of Guinea. This is the first time it is detected in Guinea and West Africa. Marburg virus is one of the world's most threatening diseases, causing severe haemorrhagic fever, with a case fatality rate of 90%. Currently, there are no vaccines and specific antiviral drugs for MVD. Technical teams and community health care workers that were set up as part of the recent Ebola virus disease (EVD) outbreak that was declared over on June 19, 2021, are now redeployed to support governments response activities of the MVD outbreak in the country. The MVD is an added burden to the fragile healthcare systems that are already overburdened with multiple reoccurring epidemics and the COVID-19 pandemic. Previous epidermic strategies are needed to contain the spread of the disease, amid the COVID-19 pandemic, so the health care systems are not overwhelmed. This commentary discusses the available evidence regarding the epidemic of MVD in Guinea amid the COVID-19 pandemic, and highlights the efforts, challenges to be prioritized, and provides evidence-based recommendations.

Background: In the wake of coronavirus (COVID-19) global alert, people have begun to practice safety measures in order to reduce the exposure to life-threatening disease. The largest at risk population is undoubtedly the frontline healthcare workers (HCWs) who are using personal protective equipment (PPE), essentially face masks, to battle against this deadly virus. This study was conducted with the prime intention to reveal an association between face mask and acne and measure the prevalence of acne amongst HCWs amidst COVID-19 outbreak in Karachi. Furthermore, this study aimed to identify the type of mask generating acne, locate the common sites, assess the severity and establish an association of mask use with the skin type.

cardiac abnormalities, asthma, or renal disorder. In addition, those in an immunedeficient state, such as diabetes or HIV infection, are further at risk of acquiring COVID-19. Moreover, according to the CDC, people who were financially unstable, socially isolated, and homeless even before the pandemic appear to be at a higher risk and powerless against this pandemic. 3 The impact of quarantine is likely to be more severe in already disadvantaged communities such as transgender people, especially with lockdown protocols, social distancing, economic burden, isolation, and limited access to community and religious activities, which can further deteriorate their mental well-being. 3 Transgender people are those individuals whose gender identity differs from the sex they were designated at birth. 4 According to the World Professional Association for Transgender (WPATH) Standard of Care, trans people are a diverse group who cross or transcend culturally recognized

Laurence-Moon-Bardet-Biedl syndrome (LMBBS), a rare autosomal recessive genetic disorder, results from consanguineous marriage. It is a congenital ciliopathy manifesting with primary and secondary characteristics. Primary clinical features include rod and cone dystrophy, polydactyly, central obesity, genital abnormalities, and mental retardation, often presenting as poor schooling skills. Secondary clinical features include developmental delay, speech deficit, brachydactyly/syndactyly, dental defects, ataxia, olfactory deficit, diabetes mellitus (DM), and congenital heart disease. Herein, we report a case of a 15-yearold male with clinical manifestations of LMBBS, namely learning disabilities, night blindness, hypogonadism, polydactyly, polysyndactyly, and obesity. Physicians must be familiar with this syndrome, for which an early diagnosis, multidisciplinary approach, and regular follow-ups can profoundly diminish morbidity and mortality in LMBBS patients.

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This a preprint and has not been peer reviewed. Data may be preliminary.

Mooren's ulcer, a rare ophthalmic disease, presents clinically as a painful, chronic, peripheral corneal ulceration of unknown etiology with some autoimmune origin evidence. It begins with an intense limbal inflammation, leaving behind an opaque cornea. If left untreated, progressive damage and corneal degeneration can lead to permanent loss of vision. Herein, we present a classic case of Mooren's ulcer in the right eye of a 60-year-old male patient with no known comorbid condition. No underlying systemic disorder being the rarity in our case, the cause remains idiopathic. The patient was previously diagnosed with having Mooren's ulcer in his left eye 10 years ago. Despite multiple topical treatments and surgical interventions, there was a complete loss of vision. He presented exaggerated manifestations, including pain, redeye, watery eye, photophobia, and the progressive decline of vision. A combination of multiple pharmacological and surgical interventions, including lateral tarsorrhaphy, amniotic membrane grafting, conjunctival flap, and scleral patch graft, was tried to ameliorate the affected eye but failed to salvage the eye permanently.

BackgroundVitamin D is a vital micronutrient and plays a vital role in defining the bone mineral density of an individual. There are many factors that regulate the levels of vitamin D in our body. The deficiency in vitamin D leads to various complications, with the most important one weakening of bones. Adolescence defines the degree of bone mineral density, which reduces with the growing age in a gradual fashion. MethodsThe study was a cross-sectional study conducted in Zarghoon town, Quetta, Pakistan. A sample size of 142 was taken from urban and rural areas. Participants were adolescent girls falling in the age bracket of 13-18 years. The circulating level of 25-hydroxy vitamin D was assessed using the ELISA (enzyme-linked immunosorbent assay) technique. Data were analyzed with SPSS Version 20 (IBM Corp.). ResultsOverall, vitamin D deficiency was 32.4%, and 9.9 % of girls were found to be severely deficient, where the highest proportion belonged to urban samples. The prevalence rate of vitamin D insufficiency was 39.4%. The urban population had a higher prevalence of low levels of vitamin D. In urban respondents, 49.1% had an insufficient vitamin D level, 33.3% had a deficient vitamin D level, and 17.5% had a severely deficient vitamin D level. In rural respondents, 47.1% had normal vitamin D levels, 32.9% had insufficient vitamin D levels, 15.3% were deficient, and 4.7% were severely deficient. ConclusionIt was concluded that vitamin D deficiency has a high prevalence among adolescent girls of school age. Additionally, it is more prevalent in urban areas than in rural areas.