Sudden bilateral sensorineural hearing loss (SNHL) is a rare but debilitating complication of bacterial meningitis, which is most commonly caused by Streptococcus pneumoniae . While corticosteroids are a standard intervention to reduce inflammation and protect auditory function, adjunctive hyperbaric oxygen therapy (HBOT) may offer additional benefit, particularly in steroid-refractory cases. We report the case of a 57-year-old woman who developed profound bilateral SNHL following S. pneumoniae meningitis originating from a lumbar epidural abscess. After initiating HBOT, she experienced significant subjective and audiometric improvement in hearing. This case emphasizes the importance of early recognition, multidisciplinary care, and the potential utility of HBOT in managing meningitis-related hearing loss.

Giant cell arteritis (GCA), impacting individuals over 50, causes vision loss, headaches, and jaw pain due to inflammation from proinflammatory cytokines and growth factors. Standard treatment involves glucocorticoids, with tocilizumab and tumor necrosis factor (TNF) inhibitors currently being studied. This meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines, included adult GCA patients treated with biological agents. The search covered PubMed, Medline, Embase, and Scopus until October 2023, excluding nonhuman, pediatric, non-English, and nonrandomized studies. Data were analyzed using Review Manager 5.4, with random effects models calculating odds ratios (ORs) and 95% confidence intervals (CIs). A meta-analysis of 11 studies ( n = 924) demonstrated higher remission rates with biological agents (OR = 2.58, 95% CI: 1.17-5.71; p = 0.02; I 2 = 70%), especially tocilizumab (OR = 4.30, 95% CI: 1.22-15.21; p = 0.02). Nonsignificant trends favored biological agents for relapse rates (OR = 0.52, 95% CI: 0.26-1.05; p = 0.07) and control for adverse effects (OR = 0.70, 95% CI: 0.49-1.02; p = 0.07). However, TNF inhibitors were linked to increased infection rates (OR = 2.41, 95% CI: 1.17-4.96; p = 0.02). Tocilizumab effectively induces remission in GCA patients, while abatacept and TNF inhibitors offer minimal benefits with increased infection risks, according to this meta-analysis. Treatment decisions should consider these factors, and larger studies are necessary to evaluate the safety and efficacy of biological agents in managing GCA.

Background The patient party is responsible for producing expert evidence to prove the negligence of a doctor, which becomes difficult due to lack of doctor's willingness to testify against other doctors. Impact factor (IF) is a surrogate to compare the quality of medical journals, which can be divided into low IF (< 10) and high IF (> 10). We aim to analyze various medical negligence cases where the medical journal was cited in court judgments on the parameters like court's verdict, IF of journals cited, compensation awarded, etc. Methods This is a cross-sectional descriptive analysis. Judgments were accessed from www.scconline.com . IF was accessed from Clarivate Analytics 2019 ratings. Judgments having the word "Medical" AND "Negligence" in which either patient or doctor cited any journal data as evidence were included. The ci-square test was used as test of significance. Results Twenty-six judgments met the inclusion criteria, with seven verdicts in favor of doctor (27%). The median IF was 2.455 with the New England Journal of Medicine having the highest IF (70.67). The median compensation awarded was 7.5 lakhs. The verdict of the court (doctor's win or loss) was not dependent on the IF (low IF or High IF) of the journal (chi-square = 0.16, p = 0.68). Conclusion All types of courts handling medical negligence, viz., criminal court, consumer/civil court, writ court, and medical councils, accept medical journal research papers even as the sole evidence in the case of medical negligence. Most of the journals cited were low IF journals.