ABSTRACT
Coronavirus diseases 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 virus produce opportunistic fungal infections. Mucormycosis is an acute onset rapidly progressive fatal infection. Incidence of rhino-orbital mucormycosis raised during the second wave of COVID-19 pandemic in India. Diabetes, steroid therapy, cancer, prolonged hospitalization, and metabolic acidosis are the risk factors of post-COVID-19 mucormycosis. Objectives of this study were to suggest the risk factors, clinical features, investigations, and treatment of post-COVID-19 rhino-orbital mucormycosis. This study will guide the future research and the clinician will be aware about this complication of COVID-19. After getting permission from the Institutional Ethical Committee and consent from patients, we studied 10 cases of post-COVID-19 rhino-orbital mucormycosis from April to September 2021 during our duty in COVID-19 admission desk and COVID-19 ward in NRS Medical College, Kolkata. After taking history, we observed the clinical features, investigations, and treatment of the patients. Symptoms of the patients were nasal discharge, nasal block, headache, facial swelling, and blackish discoloration of skin. Most of the patients were diabetic. Magnetic resonance imaging (MRI)-PNS was showed sinonasal mass. Amphotericin-B was used and debridement was the main surgical procedure. Microscopy showed broad aseptate hyphae suggesting mucor. Early diagnosis and proper treatment will reduce the morbidity and mortality of the patient with post-COVID rhino-orbital mucormycosis.
ABSTRACT
Background and Aim: Glioblastoma multiforme (GBM) are the most aggressive class of cancer of central nervous system with hallmark characteristics that include rampant proliferation, necrosis, and endothelial proliferation. Epidermal growth factor receptor (EGFR) has been implicated as the primary contributor to glioblastoma initiation and succession. The present study was designed to evaluate EGFR protein expression in GBM as predictor of response to therapy and survival. Materials and Methods: Epidermal growth factor receptor was assessed by immunohistochemistry as a percentage of positive tumor cells in hot spots (10 high-power fields). The study group comprised of 35 cases of GBM. All cases underwent surgical resection and subsequently underwent radiotherapy (n = 17) or radiotherapy with adjuvant temozolomide chemotherapy (n = 18). Immediate response to therapy was assessed at 3 months using World Health Organization response evaluation criteria in solid tumors criteria and cases followed up for survival. Results: Twenty-four cases (68.6%) expressed EGFR while 11/35 (31.4%) cases were negative. Response to therapy was evident in 21/35 cases (60.0%) and 14/35 were (40.0%) nonresponders. Mean EGFR protein expression in responders was 37.23 ± 33.70 and in nonresponders was 59.5 ± 39.46 (P = 0.542). The percentage of responders which were EGFR negative was 72.7% and while response in EGFR positive cases was observed in 54.2%. Mean survival in EGFR positive and negative GBM was 394.37 ± 189.11 and 420.54 ± 191.23 days, respectively. Conclusion: The EGFR negative cases appear to respond better to therapy, however, the difference is not statistically significant (P = 0.298). Further, EGFR protein expression does not play a definitive role in predicting survival. This is an original study evaluating EGFR in terms of therapeutic response.
ABSTRACT
Objective: The aim of this study was to evaluate the effect of rosiglitazone on spontaneous and clomiphene-induced cycle in polycystic ovary syndrome (PCOS) women. Methods: A randomized controlled trial was carried out on 30 women of PCOS divided into two groups of 15 each. Group I women received rosiglitazone and Group II women received both rosiglitazone and clomiphene citrate for three months. Main outcome measures: Primary outcome measures were improvement in body mass index (BMI), Hirsutism scoring and ovulation rate. Secondary outcome measures included conception rate and changes in hormonal profile. Results: Overall 20 of 30 (66.67%) women ovulated successfully. Ovulation occurred in nine of 15 women (60.00%) in Group I as compared to 11 of 15 (73.33%) in Group II (p value 0.6). Out of 30, total 53.33% became pregnant, 40% from Group I and 66.67% from Group II (p value 0.14). No significant improvement in follicle-stimulating hormone (FSH) and Hirsutism score was observed. Mean BMI of patient improved significantly and fasting insulin declined but not statistically significant. The hormonal profile showed improvement in both the groups, with decline in luteinizing hormone (LH), LH/FSH ratio and testosterone. Conclusion: Thus rosiglitazone, a wonderful insulin sensitizer, plays a significant role alone as well as in adjunct with clomiphene citrate in PCOS women.