Introduction:Acne is a prevalent condition in society affecting nearly 80-90% of adolescents often resulting in secondary damage in the form of scarring. Retinoic acid (RA) is said to improve acne scars and reduce postinflammatory hyperpigmentation while glycolic acid (GA) is known for its keratolytic properties and its ability to reduce atrophic acne scars. There are studies exploring the combined effect of retinaldehyde and GA combination with positive results while the efficacy of retinoic acid and GA (RAGA) combination remains unexplored.Aim:The aim of this study remains to retrospectively assess the efficacy of RAGA combination on acne scars in patients previously treated for active acne.Materials and Methods:A retrospective assessment of 35 patients using topical RAGA combination on acne scars was done. The subjects were 17-34 years old and previously treated for active acne. Case records and photographs of each patient were assessed and the acne scars were graded as per Goodman and Baron's global scarring grading system (GSGS), before the start and after 12 weeks of RAGA treatment. The differences in the scar grades were noted to assess the improvement.Results:At the end of 12 weeks, significant improvement in acne scars was noticed in 91.4% of the patients.Conclusion:The RAGA combination shows efficacy in treating acne scars in the majority of patients, minimizing the need of procedural treatment for acne scars.

Objective To study the profile of neurological manifestation of rickettsial disease in children. Methods Review of hospital records was done in a tertiary care hospital for the period from January to December, 2020. Data of all the children fulfilling the inclusion criteria i.e., clinical criteria and serology were retrieved from the hospital records. Results Of the total 7974 children admitted over this period, 178 were diagnosed with rickettsial disease wherein 54 (33.3%) had neurological involvement. Convulsions (59%), altered sensorium (56%), headache (44%), meningeal signs (37%), ataxia, (11%), lateral rectus palsy (7.5%) and stroke (7.5%) were the major neurological manifestations. Cerebrospinal fluid (CSF) analysis done in 30 (55%) children showed pleocytosis [median (IQR) cells 15 (3.75, 50)] with lymphocyte predominance [median (IQR) lymphocytes 11.5 (3, 38.75)] and elevated proteins [median IQR 41.5 (29.75,61)]. Neuroimaging abnormalities noticed were cerebral edema ( n =7), cerebellar hyperintensities ( n =5), basal ganglia infarcts ( n =2) and hippocampal hyperintensities ( n =1). Conclusion Early recognition of rickettsial infection as a cause of neurological manifestation would facilitate early specific management.

OBJECTIVE:To describe the demographic profile, clinical presentation and health seeking behaviour in children with vernal keratoconjunctivitis in north Bangalore. MATERIALS AND METHODS: Cross sectional survey of school children conducted between Feb 2014 to May 2014. Children were interviewed using a questionnaire on Vernal keratoconjunctivitis related symptoms. Children received a full eye examination including vision using snellen chart, slit lamp examination and fundus examination where required. RESULTS: A total of 2500 children screened, 450 children had Vernal keratoconjunctivitis related symptoms and signs. Mean age at presentation was 9.1yrs with male predominance of children. Ocular itching was the predominant symptom (88%). Majority of the patients had mixed form of Vernal keratoconjunctivitis (62%). Medical care for eye problems was sought in only 22% of the patients. Vernal keratoconjunctivitis related complications such as corneal scaring (9%), peripheral corneal neovascularization (8%) and limbal stem cell deficiency (2%) were seen. CONCLUSION: This survey of prevalence and clinical pattern of VKC shows higher prevalence rate in this area as compared to other tropical countries but the clinical pattern of VKC seen is essentially similar to that seen in other tropical countries. Long term follow up is required to ascertain the risk factors for increasing prevalence rate and the need for better primary eye care and accessibility of eye care to the population in the community.

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