Asian Pacific Journal of Health Sciences

Efficacy and Tolerability of Nixoderm Cream in the Management of Atopic Dermatitis: An Open-Label, Comparator-Controlled Clinical Study

Abhineetha Hosthota — 2026-09-22

Background: Topical formulations combining salicylic acid, benzoic acid, and precipitated sulfur have been reported to support the management of atopic dermatitis (AD) by aiding skin exfoliation, reducing microbial load, and easing inflammation. Aims: The aim of the study was to evaluate the efficacy and tolerability of Nixoderm Cream, applied twice daily, in subjects with AD, compared with a control arm. Materials and Methods: An open-label, parallel-group study was conducted at a single Centre following Ethics Committee approval. Forty two subjects diagnosed with AD per Hanifin–Rajka criteria were enrolled (Group A: Nixoderm Cream, n = 21; Group B: Control, n = 21) and assessed at day 0, 7, 15, and 30 using the Eczema area and severity index (EASI) and AD severity index (ADSI), alongside a structured patient-feedback questionnaire. Results: Group A showed statistically significant reductions in EASI and ADSI scores from baseline to day 30 in both full analysis set and per-protocol set analyses, while Group B showed slight improvement in EASI and ADSI. Between-group differences were statistically significant. No adverse events were reported in either arm. Patient-reported improvement in Group A rose to 88% by day 30. Conclusion: Nixoderm Cream demonstrated significant and well-tolerated improvement in AD severity over 30 days relative to control, supporting its potential role as a topical therapy for mild-to-moderate AD.

Efficacy and Tolerability of Nixoderm Tin in the Management of Atopic Dermatitis: An Open-Label, Comparator-Controlled Clinical Study

Abhineetha Hosthota — 2026-09-22

Background: Topical formulations combining salicylic acid, benzoic acid, and precipitated sulfur have been reported to support the management of atopic dermatitis (AD)/eczema by aiding skin exfoliation, reducing microbial load, and easing inflammation. Aims: The aim of the study is to evaluate the efficacy and tolerability of Nixoderm Tin, applied twice daily, in subjects with AD, compared with a control arm. Materials and Methods: An open-label, parallel-group study was conducted at a single center following ethics committee approval. Forty subjects diagnosed with AD per Hanifin-Rajka criteria were enrolled (Group A: Nixoderm Tin, n = 20; Group B: Control, n = 20) and assessed at day 0, 7, 15, and 30 using the eczema area and severity index (EASI) and AD severity index (ADSI), alongside a structured patient-feedback questionnaire. Results: Group A showed statistically significant reductions in EASI and ADSI scores from baseline to day 30 in both full analysis set (FAS) and per-protocol set (PPS) analyses, while Group B showed slight improvement in EASI and ADSI. Between-group differences were statistically significant (EASI PPS day 30, P = 0.0003; ADSI FAS day 30, P < 0.0001). No adverse events were reported in either arm. Patient-reported improvement in Group A rose to 80% by day 30. Conclusion: Nixoderm Tin demonstrated significant and well-tolerated improvement in AD severity over 30 days relative to control, supporting its potential role as a topical therapy for mild-to-moderate AD.

A Rare Case of Pleomorphic Adenoma of the Nasal Cavity with Extensive Squamous Metaplasia: A Diagnostic Pitfall

Deepak Kumar — 2026-09-22

Pleomorphic adenoma (PA) is one of the most common benign tumor of the major salivary glands. Its occurrence in the nasal cavity, particularly arising from minor salivary glands of the nasal septum, is rare. Due to its unusual location and diverse histomorphology, it is often associated with diagnostic challenges. We report a case of a 56-year-old female presenting with unilateral nasal obstruction of 3 months duration on the right side of the nose. Radiological evaluation revealed a well-defined lesion in the right nasal cavity arising from the anterior nasal septum without evidence of bone destruction. Histopathological examination established the diagnosis of PA with extensive squamous metaplasia and keratin pearl formation, imparting a morphology that closely mimics keratinizing lesions of the nasal cavity. In conclusion, PAs in the nasal cavity are uncommon and often show higher epithelial cellularity with reduced stromal components compared to their major salivary gland counterparts, which may lead to misdiagnosis, particularly in limited biopsy specimens. Recognition of such histological variations is essential to avoid overdiagnosis and aggressive treatment.

Histomorphological Analysis and Clinicopathological Correlation of Tumors and Cysts of Skin and its Appendages – A Retrospective Study at a Tertiary Care Center in Hyderabad

Keerthana Muppidi — 2026-09-22

Background: Skin tumors and cysts are a heterogenous group of lesions that have varied presentations. It is difficult to diagnose them as benign or malignant lesions as their clinical manifestations tend to overlap. Therefore, histopathological examination serves as the gold standard for diagnosis and proper patient management. Objectives: Histomorphological spectrum of skin tumors and cutaneous cysts and their correlation with clinicopathological diagnoses was evaluated in a tertiary care hospital. Materials and Methods: A retrospective observational study conducted in the department of pathology at CMR institute of medical sciences and hospital, Hyderabad over a period of two and a half years (January 2023 to June 2025). A total of 130 excised skin tumors and cutaneous cysts that were subjected to histopathological examination were included in this study. Inflammation and infection related cases were excluded from the study. The clinical details of the patient were obtained from the pathology requisition forms. Formalin fixed, Paraffin-embedded samples were examined microscopically after hematoxylin and eosin staining. Data analysis was done in Microsoft excel software and Statistical Package for the Social Sciences version 25.0 (IBM Corp., Armonk, NY, USA). Results were presented in frequencies, percentage, mean, and standard deviation. Results: Among the 130 patients studied, 72 (55.4%) were male and 58 (44.6%) were female with a mean age of 37.5 ± 18.4 years (range 1–82 years). Most cases were in the 21–40 year age group (53.1%) and posterior chest region was the most common site involved (23.1%). Epidermoid cysts were the commonest lesions (47.7%), followed by infected epidermoid cysts (13.8%) and papillomas (11.5%). Malignant tumors constituted 7.7% of the total cases studied, with the most common being squamous cell carcinoma. Clinicopathological concordance was seen in 70% of cases while 30% of the cases showed clinicopathological discordance which mainly occurred due to misdiagnosis of epidermoid cysts as sebaceous cysts clinically. Conclusion: Epidermoid cysts were the commonest cutaneous lesions seen among young adults with a slight male predominance. High clinicopathological discordance in this study emphasizes the need for routine histopathological examination to make a precise diagnosis.

Clinical and Echocardiographic Correlation of the Mitral L-Wave: An Observational Study

Ashutosh Kumar — 2026-09-23

Background: The mitral L-wave is a mid-diastolic transmitral Doppler flow signal that is often underrecognized in routine echocardiography despite its diagnostic and prognostic importance. This observational study evaluated the clinical and echocardiographic correlates of the mitral L-wave among patients attending a tertiary care general medicine department. Methods: Fifty-three patients with an echocardiographically confirmed mitral L-wave were studied over 6 months (April 2024–September 2024) at the Department of General Medicine, L.N. Medical College and J.K. Hospital, Bhopal. Clinical presentation, comorbidity profile, and the response of the L-wave to the Valsalva maneuver were recorded and analyzed descriptively. Results: A mitral L-wave was frequently observed in patients with coronary artery disease and chronic kidney disease (50.9% each), and hypertension and type 2 diabetes mellitus (49.1% each), consistent with elevated left ventricular filling pressures. Dyspnea on exertion (62.2%) was the most common presenting symptom, and females constituted a slightly higher proportion (52.8%) of the cohort. Eight patients (15.1%) showed a preload-dependent change in L-wave amplitude during the Valsalva maneuver. Conclusion: The mitral L-wave is a reproducible, load-sensitive Doppler finding associated with diastolic burden that may assist in the early detection and management of heart failure with preserved ejection fraction.

Prevalence, Clinicobiochemical, and Immunological Profile of Human Immunodeficiency Virus and Human Immunodeficiency Virus–Hepatitis B Virus Coinfected Patients in a Tertiary Care Hospital in South India

V. C. Srinivas Reddy — 2026-09-23

Background: Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) share common transmission routes, and coinfection is known to worsen immunological recovery in both conditions; Indian data on the clinicobiochemical profile of HIV–HBV coinfection remain limited. Methods: This cross-sectional observational study, conducted at the anti-retroviral therapy (ART) center, Government General Hospital, Vijayawada, over 6 months, aimed to determine the prevalence of HIV–HBV coinfection, compare demographic, clinical, biochemical, and immunological profiles between HIV-monoinfected and HIV–HBV coinfected patients, and assess the association between CD4 T-cell counts and opportunistic infections. Of 1,802 HIV-positive individuals screened for hepatitis B surface antigen, 101 were coinfected (cases), and 100 HIV-monoinfected patients served as controls; data were analyzed using the Statistical Package for the Social Sciences v25. Results: The prevalence of HIV–HBV coinfection was 5.6%. Coinfection was more frequent among males (66.3%) and rural residents (73.3%, P < 0.05), with heterosexual transmission predominating (82.2%). Coinfected patients had significantly lower mean CD4 counts (214 ± 86 vs. 328 ± 112 cells/μL; P < 0.001), more advanced centers for disease control and prevention Stage C disease (50.5% vs. 35.0%), and higher rates of elevated alanine aminotransferase (63.4% vs. 26.0%) and aspartate aminotransferase (74.3% vs. 31.0%; both P < 0.001). Opportunistic infections, particularly chronic diarrhea (43.6%) and pulmonary tuberculosis (21.8%), were more common in coinfected patients. Conclusion: HIV–HBV coinfection significantly worsens immunosuppression, accelerates hepatic injury, and increases the burden of systemic opportunistic infections. Routine HBV screening in all HIV patients, early initiation of dual-active ART, and targeted rural health interventions are warranted.

Study of Clinico-Radiological Examination and Histopathological Examination in Management of Breast Lump

Sachin Sehrawat — 2026-09-23

Background: Breast lumps are among the most common presenting complaints in surgical outpatient departments, encompassing a wide spectrum from benign fibrocystic disease to invasive malignancy. Accurate early differentiation is critical to prevent diagnostic delays, reduce unnecessary surgery, and optimize patient outcomes. The triple assessment – comprising clinical breast examination (CBE), radiological imaging (ultrasonography [USG]/mammography), and fine needle aspiration cytology (FNAC) – is the internationally recommended standard for evaluating breast lumps. However, institution-specific data validating its performance in the Indian clinical context remain sparse. Materials and Methods: This prospective observational study enrolled 50 patients with palpable breast lumps at SGT Medical College, Gurugram, between 2024 and 2026. All patients underwent structured CBE, radiological assessment (USG ± mammography) classified by the Breast Imaging Reporting and Data System (BI-RADS), and FNAC classified by the C1–C5 cytology grading system. Histopathological examination (HPE) served as the reference standard. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and Cohen’s kappa (κ) were computed. Results: Of 50 patients (mean age 38.6 ± 9.4 years), 32 (64%) had benign and 18 (36%) had malignant lesions on HPE. Key malignancy-associated clinical features included puckering/dimpling (66.7% vs. 9.4%; P < 0.001), peau d’orange (50.0% vs. 3.1%; P < 0.001), and axillary lymphadenopathy (72.2% vs. 9.4%; P < 0.001). All BI-RADS 5 lesions (100%) were histologically malignant. FNAC: Sensitivity 94.4%, specificity 90.6%, accuracy 92.0%. Kappa values: Clinical κ = 0.71, radiology κ = 0.79, FNAC κ = 0.84, triple assessment κ = 0.88. Conclusion: Integrated triple assessment achieves near-perfect concordance with histopathology (κ = 0.88) and represents the optimal diagnostic strategy for breast lumps. FNAC is the most accurate single modality. Multicentric studies with larger cohorts are warranted.

The APACHE 3 Prognostic System Risk Prediction of Hospital Mortality in Critically Ill Hospitalized Adults in Medical Intensive Care Unit on Mechanical Ventilation in Tertiary Care Center

Somesh Haridas Nagre — 2026-09-24

Background: Critically ill patients requiring mechanical ventilation have substantial morbidity and mortality, necessitating reliable tools for severity assessment and outcome prediction. The Acute Physiology and Chronic Health Evaluation III (APACHE III) scoring system incorporates physiological variables, age, and chronic health conditions to estimate hospital mortality. Materials and Methods: A prospective observational study was conducted among 120 patients requiring mechanical ventilation in the 10-bedded intensive care unit (ICU) of New Civil Hospital, Surat, from May 2018 to October 2019. Demographic characteristics, indications for ventilation, ventilator-related parameters, comorbidities, clinical findings, and laboratory investigations were recorded. The worst physiological parameters during the first 24 h of ICU admission were used to calculate the APACHE III score. Predicted mortality was calculated using the APACHE III mortality equations and compared with observed hospital mortality. Results: The majority of patients were aged 18–30 years (48.3%), and 77% were male. Neurological conditions were the most frequent broad indication for mechanical ventilation (67%), with organophosphorus (OP) poisoning being the most common individual diagnosis (50%). Most patients required ventilation for 1–7 days (60%). Overall, 48 patients (40%) died, whereas the mean predicted mortality was 32% and the mean APACHE III score was 62. Higher APACHE III scores were significantly associated with increased mortality (χ2 = 72.018, P < 0.001). A significant association was also observed between mortality and comorbidities (P < 0.001) and PaO2 levels (P < 0.001). Among patients with OP poisoning, APACHE III score was strongly associated with mortality (χ2 = 21.071, P < 0.001). Conclusion: APACHE III demonstrated good prognostic utility and effectively stratified mortality risk among mechanically ventilated ICU patients. Higher scores were strongly associated with increased observed mortality, supporting its use for outcome prediction in critically ill patients.

Hand-foot Anthropometric Correlates of Stature among Undergraduate Medical Students: A Cross-sectional Study

Appala K. Sateesh M — 2026-09-29

Background: Stature is an important anthropometric characteristic with applications in biological anthropology, clinical assessment, and forensic identification. When complete skeletal remains or an intact body are unavailable, measurements of peripheral body parts such as the hand and foot may provide useful information for estimating stature. However, anthropometric relationships are population-specific and may vary according to sex, age, geographical background, and body proportions. This study evaluated the relationship between hand and foot anthropometric parameters and stature among undergraduate medical students and explored sex-specific prediction models. Materials and Methods: A cross-sectional observational study was designed among 240 undergraduate medical students aged 18–24 years. Stature, bilateral hand length, hand breadth, foot length, and foot breadth were measured using standardized anthropometric procedures. Pearson correlation analysis was performed to determine associations between anthropometric variables and stature. Independent-samples t-tests were used to compare measurements between male and female participants. Multiple linear regression models were developed to evaluate the predictive contribution of hand and foot measurements. Model performance was assessed using R2, adjusted R2 and standard error of estimate (SEE). Results: In this study, 120 males and 120 females were included. Mean stature was 170.64 ± 5.89 cm among males and 158.80 ± 5.93 cm among females. All measured hand and foot parameters demonstrated positive correlations with stature. Right foot length showed the strongest overall correlation with stature (r = 0.909), followed by left foot length (r = 0.908) and right hand length (r = 0.894). A combined model incorporating right hand length and right foot length explained 88.4% of the variance in stature in the overall simulated sample (adjusted R2 = 0.883; SEE = 2.73 cm). Conclusion: This study demonstrates that hand and foot anthropometric dimensions are positively associated with stature and that combined hand-foot measurements may provide better prediction than individual parameters. Population-specific and sex-specific regression equations may be useful in anthropometric and forensic applications.

Clinical Spectrum and Surgical Management of Hand Glomus Tumors: A Case Series of Five Histopathologically Confirmed Cases

Sumit Jain — 2026-09-28

Background: Glomus tumors are rare benign neoplasms arising from the glomus body and most commonly occur in the subungual region of the digits. Despite their small size, they characteristically cause severe localized pain, point tenderness, and cold hypersensitivity, often resulting in delayed diagnosis. This case series describes the clinical presentation, anatomical distribution, diagnostic evaluation, surgical management, and outcomes of five histopathologically confirmed glomus tumors of the hand. Case Series: We retrospectively reviewed five consecutive patients with histopathologically confirmed glomus tumors who underwent surgical excision at a tertiary care center. The patients included three women and two men, aged 34–49 years. Three tumors were subungual, involving the right thumb, left thumb, and right little finger; one involved the fingertip pulp of the right ring finger; and one was located on the dorsum of the right hand. Patients presented with chronic localized pain, with cold hypersensitivity and point tenderness documented in the clinically typical lesions. Imaging was performed selectively for lesion localization. Complete surgical excision was achieved in all cases through an approach tailored to the anatomical location, including transungual, direct pulp, and dorsal approaches. Histopathological examination confirmed glomus tumor in all five cases. During follow-up, all patients reported complete resolution of pain, with no documented recurrence or significant post-operative nail deformity. Conclusion: Glomus tumors should be considered in patients presenting with persistent, localized digital pain, particularly when associated with point tenderness and cold hypersensitivity. Although the subungual region is the most common site, lesions may occur in atypical locations such as the fingertip pulp and dorsum of the hand. Careful clinical assessment, appropriate imaging when indicated, complete surgical excision, and histopathological confirmation are essential for accurate diagnosis and effective treatment. Early recognition may reduce diagnostic delay and facilitate excellent symptomatic outcomes.