ABSTRACT
Introduction: Coronavirus disease associated mucormycosis (CAM), perturbed a lot by reaching to epidemic proportions particularly during the second wave of the pandemic. Material and Methods: This was a retrospective, observational study of patients with COVID-19-associated mucomycosis admitted in April-May 2021 at a tertiary care teaching hospital. Demographic profile, clinical and laboratory parameters were recorded Multidisciplinary treatment including antifungals and surgical interventions were noted. Results: This study included 98patients of mucormycosis, diagnosed on the basis of clinical and radiological findings and later were confirmed by microbiological investigations. Out of 98 patients, 72 had rhino orbital, 24 had rhino-orbital- cerebral and 2 had pulmonary mucormycosis. Twelve had coinfection of covid 19 while 86 had developed mucormycosis within 3 weeks. Conclusion: CAM has posed as a continuum of challenges faced during the pandemic of covid 19. This rare and life threatening complication requires high index of suspicion for early diagnosis. Multidisciplinary involvement and timely interventions including antifungal pharmacotherapy, stringent glycemic control and surgical debridement can reduce the mortality. Mucormycosis is uniformly associated with low iron levels but role of zinc needs to be further studied
ABSTRACT
Background: Owing to the recent demographic shifts and negative lifestyle changes, stroke is one of the leading causes of mortality across every income group in most of the countries. It is of the utmost importance to devolve into the clinical profile, etiology and management of patients with acute ischaemic stroke.Methods: It is a prospective case control study. Data was collected using a pre-tested pro forma meeting the objectives of the study. Patients who consented were divided into two groups and complete examination and investigations were carried out.Results: There were 94 patients with AIS enrolled for the study. The mean age was 56.2 years, of which 68.08% were males and 31.92% were females. The mean time for these patients to reach the health facility was 12.6 hours and only 36.17% of patients reached in the window period of 4.5 hours and were eligible for thrombolysis. Hypertension, Diabetes and smoking were the most common risk factors in this order among others.Conclusions: There is poor awareness regarding identification of stroke related symptoms and warning signs as majority of patients were unable to reach the hospital in the window period making them ineligible for thrombolysis. The leading etiology runs in the direction of modifiable risk factors which can be corrected at a primary prevention level.
ABSTRACT
Background: Comorbidity of diabetes and tuberculosis has serious health implications. Presence of diabetes at least three times increases the risk of tuberculosis which may be mediated by an abnormal innate immune response due to hyperglycaemia or low vitamin D levels.Aim of the study- Present study was carried out to investigate whether lower serum 25(OH) D might be associated with higher prevalence of pulmonary or extra pulmonary tuberculosis which might provide an evidence for a role of vitamin D in the comorbidity of these two diseases and does it have any correlation with glycemic status.Methods: In a hospital based cross sectional study, 264 patients with newly diagnosed tuberculosis were enrolled and according to glycemic status they were divided into three groups. They were assessed for vitamin D deficiency in addition to routine laboratory and biochemical parameters.Results: The patients with diabetes had significantly lower vitamin D levels. The prevalence of severe vitamin D deficiency was highest in patients who had diabetes with tuberculosis. There was negative correlation between vitamin D levels and Hba1C and extensiveness of pulmonary tuberculosisConclusions: Serum vitamin D levels were significantly lower in tuberculosis patients with pre-diabetes and type 2 diabetes compared with those, who had normal glycemic status. We suggest that there is a need to pay more attention to vitamin D status in this country and if there is coexisting diabetes or impaired glucose intolerance, emphasis on vitamin D supplementation can be of utmost importance.