Introduction Dental surgery assistant (DSA) trainees experience stress from steep clinical learning curves and heavy workloads. A two-part Mental Wellness module, incorporating PERMA-based positive psychology, coping practices, role-playing and team-building, was implemented for the 2024 cohort to promote psychological well-being. Methods An anonymous pre- and post-module survey included: (i) the 22-item Psychological General Well-Being Index (PGWB) assessing six domains (anxiety, depression, positive well-being, self-control, general health, vitality); (ii) five mental health knowledge items; (iii) four lifestyle behaviour items; and (iv) 13 items on perceptions of mental well-being and dental clinic work. Descriptive statistics were calculated and Cronbach’s α assessed internal consistency. A post-module focus group ( n = 8) was analysed thematically. Results Eight trainees completed the pre-module survey and seven completed the post-module survey (100% vs 87.5% response rate). PGWB total score improved from 48.9 (95 % CI 33.1–64.6) to 59.4 (95% CI 39.8–79.1), with positive shifts across domains (positive well-being, self-control, vitality, anxiety). Cronbach’s α indicated good reliability for PGWB (α = 0.97 pre; α = 0.98 post) and perceptions of dental clinic work (α = 0.83). Fewer trainees reported feeling depressed or anxious, and confidence in program completion increased. Thematic analysis identified five themes: stress triggers, personal coping strategies, perceptions of well-being, positive experience of the module, and future application. Trainees valued experiential activities and practical coping tools, though lifestyle changes remained limited. Conclusion The module improved self-reported psychological well-being, enhanced mental health knowledge, and fostered resilience and self-awareness among DSA trainees.
Introduction This prospective observational study evaluated outcomes among patients receiving standard management alone compared with those receiving standard management with adjunct acupuncture for moderate acute asthma in the Short Stay Unit (SSU) of the Emergency Department (ED). The primary objective was to compare SSU-to-inpatient admission rates between the two groups. Methods We conducted a comparative observational study in the SSU of the ED at Changi General Hospital (CGH), Singapore between May 2019 and February 2020. Patients presenting with moderate asthma exacerbations were classified into two exposure groups according to whether they received acupuncture during their SSU stay. The Control Group received standard management while the Acupuncture Group received acupuncture in addition to standard care when licensed TCM physicians were available on-site. The primary outcome was SSU-to-inpatient admission rates. Peak expiratory flow rate (PEFR) before and after acupuncture treatment was evaluated as a secondary outcome. Results The Acupuncture Group demonstrated a lower SSU-to-inpatient admission rate compared with the Control Group (42.9% vs 83.3%), although the difference did not reach statistical significance (odds ratio 0.15, 95% CI 0.00–2.97, p = 0.135). Among participants who received acupuncture, PEFR improved significantly following treatment. Conclusion In this small observational study, adjunct acupuncture was associated with a lower inpatient admission rate and immediate improvement in PEFR. Although limited by small sample size and non-randomised design, these findings provide preliminary real-world evidence supporting further investigation of acupuncture in acute asthma care.
Primary Epstein-Barr virus (EBV) infection typically presents as infectious mononucleosis (IM), a clinical syndrome characterised by fever, pharyngitis and cervical lymphadenopathy. We describe a previously healthy 26-year-old woman who presented with fever and right-sided abdominal pain. There was no associated pharyngitis or enlarged cervical lymph nodes. Laboratory investigations demonstrated atypical lymphocytosis with a mixed hepatocellular-cholestatic pattern of liver enzyme derangement. Initial contrast-enhanced computed tomography of the abdomen and pelvis (CTAP) was unremarkable. As polymerase chain reaction was positive for EBV DNA (6290 copies/ml) in her serum, she was initially managed as for EBV hepatitis. Over 5 days, her abdominal pain worsened with development of positive Murphy’s sign and repeat CTAP demonstrated a distended gallbladder with diffuse mural oedema without cholelithiasis, suggestive of acute acalculous cholecystitis (AAC). She made a full recovery with supportive management alone. AAC is a rare complication of primary EBV infection and may occur without features of IM. Early in the course of AAC, Murphy’s sign may be absent, and CT may be non-diagnostic. Clinicians should maintain a high index of suspicion for AAC in patients with primary EBV infection who have right sided abdominal pain. Repeat imaging may be required if abdominal findings progress.
Hard Metal Lung Disease (HMLD) is a form of Interstitial Lung Disease that occurs due to occupational exposure to hard metals. It is clinically a hypersensitivity pneumonitis with typical radiological and histopathological findings including giant cell interstitial pneumonitis. Very rarely, it occurs due to non-occupational exposure and here we present the case of a 49 years old woman who presented with progressive breathlessness and was found to have typical features on histopathology of HMLD.
Background: Although endemic in surrounding countries, the true burden of histoplasmosis in Singapore is not well-defined and likely underestimated due to under-diagnosis. This case report describes a case of fatal chronic disseminated histoplasmosis in an elderly immunocompetent Singaporean male without recent travel. Case Report: A 77-year-old male presented with a 3-month history of generalised weakness and loss of weight. As investigations revealed bilateral calcified pulmonary nodules, bilateral adrenal enlargement, cytopenias, and non-parathyroid hormone-mediated hypercalcaemia, he was evaluated for tuberculosis. He later developed massive gastrointestinal bleeding and he underwent emergent endoscopythat revealed ulcerative nodular lesions in the duodenum and throughout the colon. Biopsies of the lesions showed numerous 2-4 mu m intracellular yeasts within histiocytes in the lamina propria, suggestive of histoplasmosis. Based on the pathological finding, he was started on amphotericin B on day 26 of admission, but passed away 1 day later from refractory hypotension. Histoplasma capsulatum eventually grew on fungal blood culture. Conclusion: This case highlights the need for greater awareness of histoplasmosis among clinicians in Singapore. Because Histoplasma capsulatum can reactivate several years after exposure, and chronic disseminated histoplasmosis can occur in the immunocompetent elderly, histoplasmosis should be considered and specific diagnostic testing be undertaken whenever there is a compatible clinical syndrome, regardless of travel history and immune status. As disseminated histoplasmosis can be fatal, a high index of clinical suspicion is crucial to ensure timely diagnosis and treatment.
Introduction Chronic kidney disease-associated pruritus (CKD-aP) affects up to 50% of dialysis patients and significantly impairs quality of life. Despite its prevalence and impact, CKD-aP remains under-recognized and undertreated in clinical practice. Methods A narrative review was conducted using PubMed, Scopus, and Google Scholar. Studies were selected based on clinical relevance, methodological rigor, and focus on validated patient-reported outcome measures (PROMs) and therapeutic trials, particularly involving gabapentinoids and κ-opioid receptor agonists. Key topics were reviewed jointly by nephrology and dermatology specialists, who collaborated to develop a synthesized management algorithm and treatment summary table through expert discussion. Results This interdisciplinary review provides an overview of CKD-aP pathophysiology (Figure 1) and outlines a diagnostic algorithm (Figure 2) incorporating symptom screening, exclusion of differential diagnoses, and PROM-based severity assessment. A stepwise treatment approach is presented (Figure 3), beginning with emollients, followed by gabapentinoids, and advancing to difelikefalin—the first FDA (United States), EMA (European Union) and HSA (Health Sciences Authority) of Singapore-approved treatment for moderate-to-severe CKD-aP. The review is designed as a user-friendly resource for clinicians and nurses, regardless of their specialty background. Conclusion CKD-aP is a complex and distressing condition requiring greater awareness and multidisciplinary care. While effective therapies like difelikefalin exist, their use is limited by cost and unfamiliarity. Future priorities should include improving access, comparing available treatments, exploring alternative drug delivery routes, and integrating quality-of-life assessments into routine care.
Background The endemicity of COVID and resultant social upheaval can result in significant levels of burnout. In healthcare establishments already saddled with high workloads and heavy reliance on foreign-born staff, this may create even higher levels of burnout and worsen staff turnover. Objectives The aim of this study was to evaluate factors affecting burnout among Allied Health Professionals (AHPs) in a tertiary hospital in Singapore. We hypothesized that female gender, younger age, relative inexperience, singlehood, and lack of family locally is associated with higher odds of burnout and that perceived social support and satisfaction with use of leisure time would help mitigate against burnout. Methods An anonymized email survey of AHPs was conducted. Survey instruments used were the Oldenburg Burnout Inventory, Leisure Time Satisfaction Survey, Patient Health Questionnaire-4 items, Brief form of Perceived Social Support Questionnaire, and the Demand Control Support Questionnaire. Results We received 136 responses, of which 69.9% ( n = 95) were female. Burnout was associated with younger personnel (20–29 years old), less social support at work, and those with shorter duration of residence in Singapore (≤15 years) ( p < 0.05). Burnout was also associated with psychological distress, where those with higher PHQ scores had higher odds of experiencing burnout ( p < 0.05). Contrary to hypothesis, gender, singlehood, work experience, lack of immediate family residing locally, social support outside of work and satisfaction with leisure time were not significantly associated with the odds of burnout. Conclusion Younger AHPs with less support at work and less time residing in Singapore have higher odds to experience burnout. There is a need to implement individual and organizational interventions that target those with the greatest risk factors for burnout.
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized non-atherosclerotic cause of acute coronary syndrome (ACS), particularly affecting young women in the peripartum or postpartum period. We report the case of a 39-year-old woman, 3 months postpartum and breastfeeding, who presented with acute central chest pain radiating to the left arm and associated dyspnea. She had no cardiovascular risk factors. Her electrocardiogram showed dynamic T-wave inversions in the anterolateral leads, and high-sensitivity troponin-T was elevated at 454 ng/L. Transthoracic echocardiography demonstrated a left ventricular ejection fraction of 45% with apical hypokinesis. Coronary angiography demonstrated a 99% stenosis in the mid-left anterior descending artery, consistent with type 2 SCAD. The patient was hemodynamically stable and managed conservatively with beta-blocker, ACE inhibitor, and dual antiplatelet therapy. Breastfeeding was discontinued following shared decision-making due to concerns over medication safety. Screening for fibromuscular dysplasia with CT angiography of the carotid and renal arteries was unremarkable. At 6 months, CT coronary angiography showed complete resolution of the dissection and normal coronary anatomy, allowing cessation of antiplatelet therapy in line with the patient’s preference to resume breastfeeding. Interval echocardiography also demonstrated recovery of left ventricular ejection fraction to 62%. This case highlights the importance of considering SCAD in young postpartum women presenting with ACS. Prompt diagnosis and tailored conservative management can result in excellent outcomes. Longitudinal imaging, medication review, and reproductive counselling are essential in the follow-up of such patients with the need for patient-centered care in the context of breastfeeding and future pregnancies.
Severe asymptomatic hypertension (historically termed “hypertensive urgency”) is common in hospital settings and is frequently overtreated. In the absence of acute target organ damage, aggressive short-term blood pressure reduction or parenteral therapy is not recommended. Many patients experience spontaneous decline in blood pressure with rest. In fact, observational studies in non-cardiac inpatients link antihypertensive intensification to increased risk of hypoperfusion to the vital organs. We present a real case illustrating harm from rapid multi-drug stacking and then review a practical approach to management. In line with the latest AHA/ACC 2025 Hypertension Guidelines, we urge all medical practitioners to retire the emotive label of “hypertensive urgency” and adopt “severe asymptomatic hypertension” which better reflects the evidence.
Background Paranasal sinus fungal balls are typically non-invasive and can be managed conservatively in the immunocompetent. In the immunocompromised, life-threatening invasive transformation is possible. The temporal relationship between onset of fungal balls and invasive transformation is poorly understood. We report a patient with lymphoma undergoing chemotherapy, with multiple surveillance scans demonstrating evolution from non-invasive to invasive fungal disease. Results A 67-year-old male with multiply relapsed angioimmunoblastic T-cell lymphoma received multiple regimens of systemic chemotherapy over 2 years. During the latest course of romidepsin-azacitidine, he developed right frontotemporal headaches, right V2 numbness, and vertical diplopia. Cross-sectional imaging revealed an erosive soft tissue mass along the right orbital floor and inferior rectus without necrosis, and contiguous hyperdense material within the right maxillary sinus, suggesting superimposed fungal colonisation. Our suspicions were of lymphoma progression, or a second primary neoplasm. Histopathology from intralesional biopsies revealed Aspergillus with tissue invasion without angioinvasion. Retrospective review of multiple surveillance scans performed up to 1 month prior demonstrated presence of a right maxillary sinus fungal ball. He was treated for invasive fungal sinusitis with voriconazole and debridement. He remains well on prophylactic oral voriconazole while on chemotherapy. Conclusions Our report describes the timeline of invasive transformation of a paranasal sinus fungal ball in an immunocompromised host. Further studies are needed to understand its chronology. Invasive disease can also appear mass-like without clinically apparent necrosis, mimicking neoplasms. Due to its high mortality, vigilance and surgical removal is strongly advised in patients with paranasal sinus fungal balls planned for immunosuppression, and even immunocompetent or diabetic patients.
Background Malnutrition in children includes both undernutrition and overnutrition, each contributing to distinct metabolic disruptions with long-term health consequences. Understanding these biochemical patterns can improve how malnutrition is detected and managed. Objective This scoping review aimed to explore and summarize current research on the metabolites associated with various forms of childhood malnutrition. Methods A broad literature search was conducted using PubMed, Web of Science, EBSCO, and Google Scholar to identify studies that analysed metabolic profiles in children experiencing different types of malnutrition, including obesity, stunting, and underweight. Results The findings revealed consistent changes in pathways related to amino acids and lipids. Obesity in children was associated with elevated levels of branched-chain amino acids (BCAA) and acylcarnitines, showing emerging associations with insulin resistance. Stunted growth was linked to lower levels of essential amino acids and polyunsaturated fatty acids. Several studies also reported reduced concentrations of specific lipid metabolites, particularly lysophosphatidylcholines, across various malnutrition conditions. Some metabolic markers, such as BCAAs and leptin, were found to correlate with growth and nutritional status. However, results varied across different populations. Conclusion The findings suggest that metabolomics has potential as a complementary tool for understanding malnutrition pathophysiology. However, additional research is necessary to validate these metabolites and explore their applicability in clinical practice. The observed variations in metabolic profiles across different populations highlight the importance of context-specific interpretation when applying these metabolites in clinical or research settings.
Palliative care plays an important role in intensive care units, where critically ill patients and their families often experience significant psychosocial, emotional and spiritual needs. One significant factor enhancing the quality of life for dying patients is being able to achieve a sense of relationship completion during end of life. Allied health professionals such as music therapists and medical social workers play an important part in managing the psychosocial aspects of the care of the dying patient. However, data on collaborative efforts between these professionals to support the sense of emotional and relational completion is under-reported. This paper presents two case reports illustrating the collaborative roles of a board-certified music therapist and medical social worker in facilitating this completion for imminently dying patients and their loved ones in critical care. Data was extracted from the institution’s electronic medical records. Consent for de-identification publication was sought.
BackgroundMetabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver disorder that increases the risk of cirrhosis and liver-related death. Despite its growing prevalence, effective pharmacological treatments remain limited. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as potential agents capable of improving liver histology in patients with MASH.ObjectiveThis study aimed to evaluate the efficacy and safety of GLP-1 receptor agonists in promoting histological resolution of MASH and improving liver fibrosis in adults with biopsy-confirmed disease.MethodsWe systematically searched PubMed, Embase, Cochrane CENTRAL, and Scopus from inception to 27 June 2025 for randomized controlled trials comparing GLP-1 receptor agonists with placebo in adults with biopsy-proven MASH. The primary endpoint was MASH resolution without fibrosis progression; secondary endpoints were >= 1-stage fibrosis improvement and any adverse events. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool. Pooled risk ratios (RRs) were estimated using a random-effects model.ResultsThree RCTs with a total of 1,172 participants were included. Treatment with GLP-1RAs significantly increased the likelihood of MASH resolution without fibrosis progression (RR = 2.04; 95% CI: 1.53-2.72; I2 = 19%). GLP-1RAs also improved fibrosis without worsening of MASH (RR = 1.53; 95% CI: 1.24-1.89; I2 = 0%). A modest rise in overall adverse events was observed (RR = 1.08; 95% CI: 1.02-1.14; I2 = 9%), primarily reflecting mild to moderate gastrointestinal symptoms.ConclusionGLP-1 receptor agonists, particularly semaglutide and liraglutide, significantly enhance histologic outcomes in patients with biopsy-confirmed MASH while maintaining a favorable safety profile. These findings highlight the potential of GLP-1RAs as disease-modifying agents for MASH, especially in individuals with metabolic comorbidities.
Background: Poisoning contributes to significant morbidity and mortality worldwide, leading to significant hospital resource needs. Toxicology teams provide expert advice and impact management and length of stay for patients. Purpose: In May 2019, the Singhealth cluster toxicology service was started, providing its consult services to all hospitals in the cluster. An audit review of the patients referred to the service over a 2-year period is presented. (May 2019-April 2021). Research Design: A retrospective audit review of consultation records was performed. Study Sample: All patients referred to the Singhealth Cluster Toxicology Service. Data collection and analysis: Patient demographics, exposure patterns, clinical presentation, interventions received, and outcome were examined and presented. Information about resource use (length of stay, critical care utilisation), together with critical poisoning cases, cases placed on extracorporeal membrane oxygenation and fatalities are reviewed and presented briefly. Results: 911 records were analysed. Most were referred from the ED (87.2%), were male (50.7%), and were in the 20-29 age group (29.9%). Most were self-referred (84.3%) with oral ingestion (81.7%) being most common and majority attending for intentional (69.9%) and deliberate self-harm. The most common poison class was analgesics (20.4%), followed by sedatives and antidepressants. There were 509 hospital admissions, with 153 patients requiring HD/ICU admission. The median length of stay was 3 to 5 days respectively. A total of 9 deaths occurred, 3 of which were undoubtedly caused by poisoning. Conclusion: The Singhealth Toxicology Service provides valuable insight in the management of poisoned patients and plays a pivotal role in harm prevention and informing resource allocation.
Background: Schwannomas are benign, slow-growing tumors that originate from Schwann cells of peripheral nerves. While commonly found in the head, neck, and flexor surfaces of extremities, their occurrence in the foot is rare, especially on the dorsal aspect. This unusual location often poses diagnostic challenges.Research design: We describe a 69-year-old male with a gradually enlarging and symptomatic right foot dorsal mass that had been present for five decades. The mass was mobile, bluish, and non-tender over the second web space. Ultrasound and MRI showed a well-defined, calcified subcutaneous mass with peripheral vascularity and heterogeneous enhancement but not definitive for schwannoma. Given the lesion's long duration, worsening symptoms, and inconclusive imaging results, surgical excision was performed. Histopathology confirmed the diagnosis of schwannoma. Postoperative recovery was smooth, except for localized numbness.Conclusion: This case highlights that schwannomas can present with atypical radiological and clinical features, and a definitive diagnosis typically depends on histopathology.
AimTo determine the effectiveness of topical sesame oil in preventing phlebitis at peripheral IV cannula sites in adult patients within a cardiovascular and cardiothoracic department of a tertiary hospital.DesignA double-blinded randomized controlled trial was conducted.MethodsParticipants were randomly assigned into control (liquid paraffin oil) and treatment (sesame oil) groups. Randomization was carried out using a Microsoft Excel generated randomized-number table using the RANDBETWEEN function. Five drops of sesame oil or mineral oil was applied to the IV cannula site at 12-h intervals, for a maximum duration of 72 h. A modified Visual Infusion Phlebitis (VIP) scale was utilized to assess for phlebitis severity before every application.ResultsA total of 263 participants were recruited. Six withdrew and seven were excluded after recruitment. 250 participants had their data analysed (121 in the treatment arm and 129 in the control arm). Three participants developed itching after the application of liquid paraffin oil and had their interventions discontinued. Results showed a lower phlebitis incidence in the treatment group (9.1%) compared to the control group (15.5%), though it was not found to be statistically significant (p = 0.12). Additionally, participants who received topical sesame oil experienced phlebitis scores no higher than 2, whereas in the control group, two participants recorded phlebitis scores of 3.ConclusionWhile this research suggests the potential benefits of topical sesame oil in preventing and reducing the severity of phlebitis, further investigation is crucial for more conclusive evidence and broader applicability.
Background Distal interphalangeal joint (DIPJ) fusion is a commonly used surgical technique for the treatment of osteoarthritis. It can be challenging due to the small size of the phalanges. Objectives This study aims to determine the nominal dimensions of middle and distal phalanges of digits in the Singapore population via radiographic measurements, to facilitate the selection of appropriate implants for DIPJ fusion. Materials and methods De-identified plain radiographs of 250 fingers from 250 adult Singaporeans from July 2020-2023 were retrospectively obtained and measured using the authors’ institution’s radiograph software. Lateral and anteroposterior diameters of the distal and middle phalanges were recorded and compared with the smallest commercially available headless compression screw (Medartis 1.7 mm) currently available in Singapore. Results Female phalanges were smaller than that of males. Anteroposterior diameters of middle phalanges in females were significantly smaller than that of males in all fingers except for the thumb and middle finger ( p < 0.05*). Anteroposterior diameters of distal phalanges in females were significantly smaller than that of males for all fingers (p < 0.05*). The compatibility rate of the Medartis 1.7 mm cannulated screw between the two genders was found to be on average: 94% in the thumb, 44% for the index finger, 38% for the middle finger, 30% for the ring finger and 12% for the little finger. Conclusion Apart from the thumb, less than 50% of the digits in the Singapore population were found to be compatible with the smallest available screw. The findings highlight the need for more suitable fixation devices or techniques for DIPJ fusion.
BackgroundThe COVID-19 pandemic has been associated with significant mortality, morbidity, and poorer quality of life (QoL) and functional health. However, its effects on older people with hip fractures have not been studied.ObjectivesThis study aims to determine the effects of the pandemic on pre-morbid functional status and QoL in older people with hip fractures.MethodsOur cohort study included 1466 patients who sustained a hip fracture between 2018 and 2021, and were divided into three groups: Pre-COVID, Early-COVID and Late-COVID. Demographic data, pre-morbid functional status and QoL were assessed using four different indices at one time point - Parker Mobility Score (PMS), Modified Barthel Index (MBI), EuroQol- 5 Dimension (EQ-5D) and Short Form 36 Health Survey (SF-36).Results47 patients (3.2%) had incomplete data available and the remaining 1419 (96.8%) patients were analysed, with 721 (50.8%), 366 (25.8%) and 332 (23.4%) patients presented in the Pre-COVID, Early-COVID and Late-COVID periods respectively. There was no significant difference in the premorbid PMS, MBI and EQ-5D between the three groups. However, PRE-COVID patients had significantly better premorbid SF-36 physical and mental component summary scores than LATE-COVID patients. There was no significant difference in the premorbid SF-36 scores between PRE-COVID and EARLY-COVID patients.ConclusionThe COVID-19 pandemic had a detrimental effect on the pre-morbid QoL of elderly hip fracture patients. These findings have important implications for downstream care provision and can help guide the development of protocols and resource allocation strategies in preparation for future pandemics.
To systematically review studies on oral frailty and its associations. Oral frailty is prevalent and yet under-recognised in the elderly. It has been linked to adverse outcomes including increased mortality, frailty and dementia. The databases were searched for published literature up to January 2024 using a prespecified search strategy. The following terms were used: ’oral’ AND ‘frailty’ The search was restricted to English publications. Two independent reviewers screened the retrieved references through the titles and abstracts to test them against the eligibility criteria for inclusion. The full texts of qualified publications were read and selected for the final decision after discussion between the two reviewers. 15 studies were identified with 12 cross-sectional studies and three prospective cohort studies. The definitions of oral frailty varied and outcomes were grouped into categories namely physical frailty, social frailty, cognition, mood, nutrition, quality of life and biochemical indices. Oral frailty results in negative outcomes such as increased physical frailty, social frailty, late life depression and deteriorating nutritional status. It could predict declining cognition and decreased health-related quality of life. This review identified associations between oral frailty and geriatric syndromes and revealed poorer outcomes in elderly with oral frailty. Early identification of oral frailty can be used to predict negative outcomes. Addressing oral frailty involves a multidisciplinary approach, combining dental care, nutrition and overall health to improve the quality of life. It is hoped that we can investigate and tailor interventions, allowing our elderly to age well and live well.
Background: Atopic dermatitis is a chronic inflammatory skin disorder that is commonly associated with pruritus, impaired skin barrier function, and reduced quality of life. Although topical corticosteroids and calcineurin inhibitors remain standard treatments, their long-term use may be limited by safety concerns, highlighting the need for effective nonsteroidal alternatives. Purpose: The purpose of this study was to systematically evaluate the efficacy and safety of tapinarof, a novel topical aryl hydrocarbon receptor agonist, in the treatment of atopic dermatitis. Research Design: This study was conducted as a systematic review and meta-analysis of randomized controlled trials. Study Sample: The study sample consisted of individual randomized controlled trials that compared topical tapinarof with vehicle control in patients diagnosed with atopic dermatitis. Data Collection and/or Analysis: A systematic literature search was performed to identify eligible randomized controlled trials. Pooled odds ratios with corresponding 95 percent confidence intervals were calculated using meta-analytic techniques to assess treatment success and adverse events. Results: Pooled analysis demonstrated that tapinarof significantly improved treatment success compared with vehicle control, with an odds ratio of 3.58 (95 percent confidence interval 2.20 to 5.82). Tapinarof was associated with a higher incidence of adverse events, with an odds ratio of 2.17 (95 percent confidence interval 1.64 to 2.88). The reported adverse events were generally mild in nature and included skin irritation and nasopharyngitis. Conclusions: Tapinarof appears to be an effective nonsteroidal topical therapy for atopic dermatitis, offering significant clinical benefits with a manageable safety profile. These findings support tapinarof as a promising therapeutic option for patients requiring alternatives to conventional topical anti-inflammatory treatments.
