Vitiligo is an autoimmune condition primarily affecting the skin where there is destruction of melanocytes characterized by pinkish-white patches on the skin. It is associated with other autoimmune diseases such as thyroid disease, rheumatoid arthritis, diabetes mellitus, and metabolic syndrome. Metabolic syndrome is a constellation of disorders including insulin resistance, hypertension, dyslipidemia, and obesity, and is considered a leading cause of cardiovascular morbidity. Simvastatin is a potent hypolipidemic drug that also possesses immunomodulating properties and is a common drug used in dyslipidemia and cardiovascular diseases. This study aimed to assess the association between vitiligo and metabolic syndrome and explore the immunomodulating properties of simvastatin for use in vitiligo. We reviewed various articles from PubMed, ResearchGate, and Google Scholar using different keywords and Medical Subject Headings and finalized 33 studies to be used in our review. The articles selected showed a positive association between vitiligo and metabolic syndrome or one of the component diseases of metabolic syndrome. The benefits of using simvastatin were also addressed by few articles attributing to its antioxidant and immunomodulating effect. However, there was no concrete explanation justifying the association between vitiligo and metabolic syndrome due to a limited number of studies and smaller sample size. Large-scale clinical trials should be conducted to evaluate the use of simvastatin as an immunomodulator in vitiligo to prevent possible metabolic complications.

Cystic fibrosis is an autosomal recessive disorder caused by a mutation in genes for cystic fibrosis transmembrane conductance regulator (CFTR) protein. CFTR gene is responsible for the production of sweat, digestive fluids, and mucus, and any mutation in this would lead to the thickening of these secretions. Cystic fibrosis is a multi-organ disorder, but 80% of patients suffer from respiratory problems due to chronic infections most commonly caused by Pseudomonas aeruginosa (P. aeruginosa). Eradication of these infections has become a challenge as P. aeruginosa has developed resistance to multiple antibiotics. In several studies, iron has been shown to play an integral role in biofilm formation, which is the predominant resistance mechanism used by P. aeruginosa to combat antibiotics. The increased iron content in cystic fibrosis patients' sputum samples explains their increased susceptibility to Pseudomonas infections. Hence in this review article, we have used the research data available on therapeutic agents that target iron as an adjuvant treatment for chronic Pseudomonas infection. We systematically screened three databases using focused words and Medical Subject Headings (MeSH) terms for relevant articles. Further, we applied the inclusion and exclusion criteria and performed a thorough quality appraisal. Thirty shortlisted relevant studies were meticulously reviewed. In our opinion, novel therapeutic approaches targeting iron such as iron chelators, gallium, and cefiderocol have potent anti-biofilm properties. Future studies and clinical trials using these approaches in the management of chronic Pseudomonas infection might help in decreasing morbidity and mortality in patients with cystic fibrosis. Exploring these approaches might also help to combat other resistant organisms whose survival is dependent on iron.

Traumatic injuries are one of the leading causes of morbidity and mortality. Precise diagnosis and management in the golden hour are key to decrease morbidity and mortality. History and physical examination alone are insufficient to avoid misdiagnosis. In this article, we tried to determine the role of a radiologist and an appropriate imaging modality in a trauma setting. We conducted a literature review of published research articles. We used the keywords imaging, trauma, imaging and trauma, and trauma imaging essentials were used on PubMed and Google Scholar. The articles published in the English language from 2015 to 2020 with full free text available were included. Using the medical subject heading (MeSH) strategy, "diagnostic imaging" (Major {Majr}) and "multiple trauma/diagnostic imaging" (Mesh) on PubMed, we identified 34 papers after applying the inclusion and exclusion criteria. Twenty articles were finally selected which included studies from 2015 to 2020 with articles focusing on the adult population and acute cases. A radiologist and imaging modalities are the essential parts of a trauma setting to lower morbidity and mortality. X-rays and Extended Focussed Assessment with Sonography for Trauma (eFAST) are the first-line imaging modality in the acute trauma setting. However, the CT scan is the most sensitive modality that should be done to avoid misdiagnosis depending upon the patient's history and physical examination.

Introduction: The outcomes of Catheter Ablation (CA) and antiarrhythmic drugs (AAD) as the first-line treatment of paroxysmal Atrial Fibrillation (AF) are unclear. The current systematic review reports the evidence on efficacy outcomes of Radiofrequency Ablation (RFA) versus antiarrhythmic drugs (AAD) among these patients. Methods: Three databases, including PubMed, Cochrane, and Google Scholar, were searched by three independent reviewers to identify relevant randomized control trials (RCTs). Results: A total of 1,145 patients across five studies were assessed in this systematic review. Among these patients, 577 were randomized to receive ablation, and 568 were randomized to receive AAD. The recurrence rate was significantly higher among patients who received AAD at 1-year and 2-year follow-ups. The health-related quality of life (HR-QoL) was significantly better in the patients who received ablation therapy. The incidence of serious adverse events was 14 (6.4%) in the ablation group and 9 (4.3%) in the AAD group. Conclusion: CA seems promising for managing AF in terms of any AF recurrence, hospitalization, and quality of life. There was no increase in side effects compared to AAD.

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