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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
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Background & objective: Leptospirosis is a zoonotic disease associated with potentially fatal consequences and a grossly underreported disease in Uttar Pradesh. However, only a few studies are available which report the prevalence of leptospirosis in this State. Hence, this study was undertaken to know the status of the disease in central and eastern Uttar Pradesh. Methods: A total of 143 serum and urine samples were collected from patients with acute febrile illness from July 2017 to March 2019. All the serum samples were tested for Leptospira by rapid IgM antibody card and IgM ELISA and urine samples were tested by real-time polymerase chain reaction (RT-PCR) to detect Leptospira DNA. All positive and 10 per cent negative sera from ELISA and RT-PCR (all rapid test positive were also ELISA positive) were sent to the ICMR-Regional Medical Research Centre, Port Blair for microscopic agglutination test (MAT). Results: Thirty eight (26.6%) out of 143 samples were positive for leptospirosis either by ELISA or RT-PCR. Positive results were eight (6%) by Rapid card, 32 (22%) by IgM ELISA, 10 (7%) by MAT, 10 (7%) by RT-PCR. In MAT, the most common serovar was Lai followed by Hebdomadis, Bangkinang and Pomona. Interpretation & conclusions: Leptospirosis was found to be one of the important causes for acute febrile illness in the central and eastern parts of Uttar Pradesh. The results of the present study suggest that it is necessary to increase diagnostic facility and awareness in clinicians for the screening of leptospirosis in acutely febrile patients to decrease morbidity and mortality associated with this disease.
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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.
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Obesity has become a matter of quality to health care administrators. The busy lifestyle of people made them prefer fast food instead of taking healthy food. But the people are not aware that fast food habit converts to the disease like obesity, type 2 diabetes mellitus (T2DM), dyslipoproteinemia etc. This case control study had been carried out in department of Physiology in collaboration of Department of Biochemistry and Medicine, Era's Lucknow Medical College & Hospital, Lucknow to explore status blood sugar fasting (BSF), tumor necrosis factor-α (TNF- α), Insulin by standard spectrophotopmetric kit methods, blood pressure (BP) as well as anthropometric measurements with the help of suitable instruments and equipments in Control group, Obese group and Obese with type 2 diabetic group. Values of all above parameters were found increased in obese group with respect to control group and values of all these parameters were found increase in obese with type 2 Diabetes mellitus group with respect to obese group. Thus it is clear that obesity is risk factor for T2DM, Dyslipoproteinemia and coronary artery disease (CAD).
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Fungal lesions of lung presenting as a mass are called mycetomas. Mycetoma is a conglomeration of cellular debris and mucous with finely woven fungal hyphae present in a cavity in pulmonary parenchyma or a bronchus.The most common infections causing pulmonary mycetoma are aspergillus.Candida species causing pulmonary mycetoma is rare. A70 year old patient of Diabetes and chronic obstructive pulmonary diseases (COPD), presented with acute on chronic respiratory symptoms. On contrast enhanced CT scan of thorax he was diagnosed as having a heterogeneously enhancing mass lesion in left lower lobe and minimal pleural effusion with a provisional diagnosis of neoplasm. Thorough examination of oral cavity revealed thrush. CT guided biopsy confirmed pulmonary candidiasis. Patient responded well to medical treatment. Only a few such cases have been reported in literature.
ABSTRACT
Hepatomegaly may be a presenting sign or symptom of the patient's illness or it may be an incidental finding in patients being examined for various other reasons At present, many patients are diagnosed with liver disease who are asymptomatic and who have been found to have hepatomegaly or abnormalities in biochemical liver tests These asymptomatic or undiagnosed liver diseases are of great concern so as to prevent various life threatening complications and better future outcome of patients. The present study was planned to explore of spectrum of causes of hepatomegaly from common to rare in a teaching hospital. In our cross-sectional study all consecutive patients >18 years old with hepatomegaly detected on clinical examination and/or in ultrasonographic assessment( liver span>15cm)attending as medical outpatient department were enrolled. Depending on the clinical diagnosis based on detailed history and clinical examination, patients were subjected to hematological and biochemical investigations as required.Both infective and non infective causes constituted two equal halves. Acute viral hepatitis and dengue fever (15% each) were the commonest infective causes of hepatomegaly. Among noninfective causes NAFLD was the most common (21%) followed by congestive heart failure (18%). Seasonal variation showed increased prevalence of infective causes during the rainy season while non-infective causes were more common in winter and autumn. Liver diseases are common in our population with diversified etiology,many are asymptomatic or may present only with liver enzyme abnormalities . There is almost equal prevalence of infective and non infective causes for hepatomegly and nonalcoholic fatty liver disease has emerged as an important cause of hepatomegaly.