Moisturizers are an important part of a dermatologist's armamentarium although little is written and well, a less is truly known about them. There is a cornucopia of projected skin products in the market whose real scientific role is not proven. These products although at times are regarded as mere cosmetics but have a well-known role in many skin disorders. Adequate knowledge about their mechanism of action, dosage, usage, and adverse effects is must for a dermatologist in this era. This article aims to bring forth the ever hidden facts of the much-hyped moisturizers. It is probably the first of its kind covering all aspects of moisturizers ranging from basic science to clinical usage, a subject that receives a short shrift in the current dermatological text.

ObjectiveTo evaluate and compare the clinical and radiological outcomes of patients with stable intertrochanteric fractures treated with proximal femoral nail vs. dynamic hip screw.MethodsSixty patients with stable intertrochanteric fractures, aged over 18 years, were randomly divided into the proximal femoral nail and dynamic hip screw groups. Dynamic hip screw with a three-hole side-plate and an anti-rotation screw were used, as well as a modified ultra-short proximal femoral nail for the smaller Asian population. The intra-operative, early and late complications were recorded, and the functional outcome of each group was assessed using the Harris Hip Score.ResultsIn the dynamic hip screw group, the one-month mean Harris Hip Score was slightly lower than that of the proximal femoral nail group. However, at the three- and six-month monthly follow-ups, the dynamic hip screw group presented higher mean scores than the proximal femoral nail group; at the one-year follow-up, both the groups attained similar scores.ConclusionProximal femoral nail provides a significantly shorter surgery with a smaller incision that leads to less wound-related complications. However, the incidence of technical errors was significantly higher in proximal femoral nail when compared with dynamic hip screw as it is a technically more demanding surgery that leads to more implant failures and the consequent re-operations.

ObjectiveTo the best of the authors’ knowledge, no studies in the literature have compared the clinical outcome of the three most common implants used to treat basicervical fractures of the femoral neck in young adults, i.e. CCS, DHS, and PFN. The present study attempts to fill the void in the literature and reach a conclusion regarding the usefulness of these implants in these fractures.MethodsThis was a prospective interventional study including 90 patients with basicervical fracture of the neck of femur treated randomly with cancellous cannulated lag screws or dynamic hip screw, with a derotation screw or short PFN.ResultsMean time for fracture union was 14.4, 13.9, and 13.5 weeks and union rate was 93.2%, 100%, and 100% in groups 1, 2, and 3, respectively. The mean Harris Hip Score at the final follow up was similar among all the groups, i.e. 79.4, 82.2, and 81.9 in CCS, DHS, and PFN groups, respectively. The highest proportion of good to excellent results was noted in the DHS group, i.e. 83.3%, whereas it was 73.6% and 80% in the CCS and PFN groups, respectively.ConclusionMultiple cancellous screws do not provide a sufficiently stable construct during fracture healing. PFN, although associated with lesser implant failures than CCS, have a higher incidence of technical errors. DHS provides sufficient stability in well-reduced basicervical fractures in young adults; it is associated with highest fracture union rates and best functional outcome out of the three implants at final follow-up.

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BackgroundNipple eczema is a less common presentation of atopic dermatitis. No studies in the literature have correlated nipple eczema in pregnancy as a manifestation of atopic dermatitis.ObjectiveTo evaluate whether nipple eczema presenting in pregnancy is a manifestation of atopic dermatitis.MethodsThis was a prospective observational study including 100 women who presented with nipple eczema for the first time during pregnancy. The exclusion criteria were any patient with previous history of nipple eczema, those already on oral or topical treatment for atopic dermatitis or nipple eczema, and other disorders mimicking eczema. Patients were divided into two groups ‒ nipple eczema with atopic dermatitis and without atopic dermatitis. Demographic data, clinical features, total leukocyte count, differential leukocyte count, absolute eosinophil counts, and serum IgE levels were compared between the two groups to detect association between nipple eczema in pregnancy and atopic dermatitis.ResultsOut of 100 patients, 39 were diagnosed with atopic dermatitis, whereas 61 were ruled out to have any features suggestive of atopic dermatitis. There were no statistically significant differences in mean age, mean duration of symptoms, and serum IgE levels. In patients with atopic dermatitis, bilateral symptoms were noted more commonly than in patients without the disease, but this was statistically insignificant.Study limitationsLack of long term follow-up and no large studies in literature to compare results.ConclusionNipple eczema in pregnancy follows a similar pattern as in other age groups. The clinical profile of patients is similar in cases with and without atopic dermatitis.

The trend of STIs is changing from bacterial to viral diseases. This is because of the widespread use of antibacterial, self-medication, and treatment through national program. STIs enhance the susceptibility of an individual to acquire or transmit HIV through sexual contact.

Type-IV supracondylar humeral fracture is a rare pattern that presents with severe instability in both flexion and extension. » These fractures cause considerable difficulty in the achievement and maintenance of reduction by means of pinning with use of closed methods and may result in malalignment and a poor outcome.» Various authors have recommended their own modifications of Kirschner-wiring techniques for the treatment of these fractures.» Four studies focusing on the treatment of this fracture, including a total of 56 type-IV supracondylar humeral fractures and 406 type-III fractures (controls), were identified. » Because of its highly unstable nature, this type of fracture poses great difficulty in achieving and maintaining reduction with use of Kirschner wires and therefore requires special techniques.» Regardless of the technique used, the outcome of type-IV fractures appears to be similar to that of type-III fractures once a stable reduction is achieved. Disclosure: No external funds were received in support of this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/ JBJSREV/A421).

Rosacea is a chronic cutaneous disorder with non specific and variable ocular manifestations. Ocular rosacea is often underdiagnosed, despite the potential for serious sight threatening sequelae. The study was designed to determine the incidence of ocular disease among the population of rosacea patients along with evaluating the presence of eye dryness in both the patients and controls using Schirmer 1 test. It correlated the severity of ocular disease with the severity of cutaneous rosacea. A total of 72 patients with facial rosacea were enrolled and evaluated with thorough history, physical and ophthalmological examination for ocular rosacea. Schirmer’s test was performed on all patients with ocular rosacea and controls. Out of 72 patients with facial rosacea, 30 (41.62%) were diagnosed with ocular rosacea. On the Schirmer test, ocular rosacea patients had statistically significant lower value than the control group. There was also a statistically significant difference between mean Schirmer test values of male patients and controls and female patients and controls. Symptoms of ocular rosacea are not always specific hence underdiagnosed. Ocular features of rosacea in patients presenting with mere cutaneous findings should not be overlooked.