Severe asthma affects 5-10% of children with asthma yet accounts for disproportionate morbidity and healthcare utilisation. The recent expansion of biologic therapies-targeting IgE, IL-5, IL-4/13, TSLP, and IL-5 receptor α-has transformed management but introduced complexity into clinical decision-making. This review provides a comprehensive, comparative analysis of currently approved biologic agents for paediatric severe asthma, with emphasis on efficacy, safety, biomarker-guided selection, and practical implementation. We searched PubMed/MEDLINE (2015-2026) for randomised controlled trials, systematic reviews, and observational studies evaluating biologic therapies in children and adolescents with severe asthma, using a narrative synthesis approach.Five biologic agents are currently approved for paediatric severe asthma. Omalizumab (anti-IgE) reduces exacerbations by 38-50% in allergic asthma (≥6 years). Mepolizumab (anti-IL-5) reduces exacerbations by 27% (rate ratio 0.73; 95% CI 0.56-0.96) in eosinophilic asthma in children and adolescents aged 6-17 years (MUPPITS-2). Dupilumab (anti-IL-4Rα) reduces exacerbations by 59% and improves lung function in children 6-11 years (VOYAGE). Tezepelumab (anti-TSLP) reduces exacerbations by 56% and is the first agent effective in T2-low phenotypes (≥12 years; NAVIGATOR). Benralizumab (anti-IL-5Rα) induces near-complete eosinophil depletion with extended every-8-week maintenance dosing; FDA approval was extended to children ≥6 years in April 2024 based on the TATE trial (SIROCCO/CALIMA/BORA/TATE). Safety profiles are generally favourable; dupilumab-associated conjunctivitis and omalizumab-related anaphylaxis require specific monitoring protocols.Biologic therapies have ushered paediatric severe asthma into the precision medicine era. Dupilumab and tezepelumab demonstrate robust efficacy across multiple phenotypes, while biomarker assessment enables rational, individualised selection.

Regulatory agencies in the United States and abroad are increasingly citing clinics and surgical facilities for what they deem to be inadequate disinfection of Goldmann applanation tonometry (GAT) tips, gonioscopy lenses, laser lenses, and other reusable clinic devices that contact the ocular surface. These regulators require routine high-level disinfection (HLD) of these reusable devices to prevent infection transmission. A multisociety task force formed to assess the necessity of HLD found no published evidence that these devices transmit sight-threatening infections or that HLD reduces infection transmission compared with lower-level disinfection methods. Meanwhile, routine use of chemical HLD reduces clinic efficiency, increases healthcare costs and waste, and may damage device surfaces potentially affecting patient care. Underlying these mandates for HLD is the nearly century-old Spaulding classification system, which inappropriately groups the ocular surface with heavily contaminated mucous membranes. A task force survey with more than 1000 ophthalmologist respondents found that the most common reprocessing methods were alcohol wiping for GAT tips and either alcohol wiping or soap and water for diagnostic or laser lenses. Many respondents using chemical HLD reported adverse effects, including ocular surface chemical toxicity and device damage. Despite infrequent use of HLD, reported infection transmission was exceedingly rare and generally limited to self-limited adenoviral conjunctivitis. The task force agreed with the majority (88%) of ophthalmologists surveyed that HLD should not be required for these reusable devices in routine clinical care. Instead, HLD should be a discretionary consideration in higher-risk circumstances, such as following use of these devices in patients with suspected infection. This paper presents the summary recommendations of a policy statement approved by the American Academy of Ophthalmology Board of Trustees and endorsed by four subspecialty societies.

BackgroundHairdressers are exposed to various occupational hazards, including musculoskeletal disorders, respiratory issues, and dermatological conditions due to prolonged standing, repetitive hand movements, and frequent contact with chemicals.ObjectiveThis study aims to assess the level of knowledge among hairdressers in Kayseri regarding occupational risk factors, determine the incidence of occupational health problems, and examine associated factors.MethodsThe study was conducted in Kayseri, Türkiye, with the participation of 286 hairdressers of both genders who provide services to women.The questionnaire consisted of 65 items divided into three constructs: sociodemographic characteristics (age, gender, education, work experience), work-related factors (work organization, PPE usage, occupational risk perception), and occupational health indicators (musculoskeletal, skin, respiratory symptoms, and general health status).ResultsAmong hairdressers, 54.5% experienced musculoskeletal symptoms, while 18.2% reported contact dermatitis symptoms and 19.6% had work-related asthma symptoms. Longer years of work experience and prolonged standing hours were found to increase ergonomic complaints.ConclusionsHairdressers with a history of atopy or precursor symptoms such as rhinitis and conjunctivitis should be screened for asthma. Ergonomic arrangements that will shorten long standing working times can reduce musculoskeletal complaints. Regular health screenings and preventive measures should be implemented to identify and manage at-risk individuals early.

Enteroviruses are among the most common viral pathogens in humans, causing illnesses ranging from the common cold to severe and sometimes life-threatening diseases such as acute haemorrhagic conjunctivitis or poliomyelitis. To replicate efficiently within host cells, enteroviruses hijack several host factors, including the lipid kinase PI4KB and the adaptor protein ACBD3. During infection, ACBD3 is recruited to viral replication sites through a direct interaction between its C-terminal GOLD domain and viral non-structural 3A proteins. Here, we identify exportin 1 (XPO1) as a host factor involved in enteroviral replication. We demonstrate that 3A proteins of various enteroviruses recruit the host proteins ACBD3 and XPO1 to form a stable ternary complex. Chemical inhibition of XPO1 with selinexor (originally developed as an anti-cancer medication), significantly attenuates coxsackievirus B3 replication in human cells. Consequently, our study identifies XPO1 as a host target for potential anti-enteroviral interventions, highlighting an immediate opportunity for drug repurposing.

Ocular infections, ranging from conjunctivitis and keratitis to postoperative and device-associated endophthalmitis, remain a significant cause of preventable visual morbidity worldwide. In India and other low- and middle-income countries, the irrational use of topical and systemic antimicrobials, often without microbiological confirmation, has contributed to the emergence of multidrug-resistant ocular pathogens. Fluoroquinolone-resistant Pseudomonas aeruginosa , methicillin-resistant Staphylococcus aureus , and resistant Fusarium and Candida species are now major challenges in ophthalmic practice. The widespread availability of over-the-counter ophthalmic drops, empirical perioperative prophylaxis, and the use of steroid-antibiotic combinations exacerbate this problem. Antimicrobial stewardship (AMS) in ophthalmology, though relatively underdeveloped, is now a global priority. The Society of Antimicrobial Stewardship PractIce (SASPI) in India advocates an integrated AMS model linking diagnostic, preventive, therapeutic, and administrative strategies. For ophthalmologists, this translates into culture-guided therapy for recalcitrant or postsurgical infections, restricting the use of broad-spectrum or prolonged topical antimicrobials, enforcing asepsis during surgeries, and adopting antimicrobial auditing systems. The RED EYE AMSP model presented in this perspective provides a ten-point, ophthalmology-specific adaptation of the SASPI framework focusing on rational prescribing, evidence-based diagnostics, environmental safety, and interprofessional partnership. By embracing stewardship, ophthalmologists can preserve antimicrobial efficacy, minimize iatrogenic resistance, and contribute to the broader One Health goal of antimicrobial resistance containment.

Ocular surface diseases (OSDs) are a heterogeneous group of disorders characterized by overlapping inflammatory, vascular, microbial, neuroimmune, and meibomian gland abnormalities that contribute to the onset and persistence of ocular surface symptoms and signs. Conventional symptom-directed therapies do not adequately alleviate refractory meibomian gland dysfunction, Demodex-associated blepharitis, ocular rosacea, recurrent chalazion, and allergic conjunctivitis. Recent evidence suggests that these conditions may share convergent pathological features, including chronic inflammation, abnormal lid-margin vascularity, and microbial or parasitic imbalance. Intense pulsed light (IPL), which was initially used for vascular and inflammatory disorders in dermatology, has emerged as a potential physical therapy that acts through several proposed mechanisms in patients with selected refractory OSDs, including photothermal liquefaction of inspissated meibum, coagulation of abnormal vessels, reduction of Demodex and microbial burden, modulation of inflammatory responses, and possible effects on neuroimmune signaling; however, these mechanisms remain incompletely established. Case series and clinical studies have reported improvements in ocular symptoms, tear film stability, meibomian gland function and drainage, lid-margin inflammation, and chalazion or lesion resolution, particularly when IPL is combined with meibomian gland expression or other adjunctive therapies. However, treatment responses vary across disease phenotypes and standardized treatment parameters, long-term safety data, and high-quality randomized controlled trials remain limited. Anatomical factors, disease severity, glandular structure, and inflammatory status may also influence therapeutic outcomes. Overall, IPL therapy represents a promising but evolving treatment strategy for refractory OSDs. This review summarizes the current knowledge regarding the proposed mechanisms, clinical applications, treatment protocols, limitations, and future directions and provides updated perspectives for the rational use of IPL in OSD management.