Clinicopathological association of mucormycosis in COVID 19 pandemic

Context: Coinfection and superadded infections in patients with coronavirus disease 2019 (COVID-19) has been reported on multiple series. The emerging second wave of the pandemic has come with a lot of changes, especially in developing countries like India. One of such changes is sudden, significant rise in mucormycosis cases. Aims: To find out clinicopathological association of invasive mucormycosis with COVID-19 infection status and immunocompromised state. Settings and Design: A cross-sectional study done at a tertiary care centre. Methods and Material: All cases admitted in the dedicated mucormycosis ward between 1-06-2021 and 15-06-2021 were included in the study. The cases were admitted with suspicion of mucormycosis. The histopathological results were correlated with KOH mount and radiological reports. The clinicopathological association of occurrence of mucormycosis in post-covid and non-COVID patients along with other risk factors. Statistical Analysis Used: Odds ratio, chi square test were used to find the association using MS Excel 2010 and SPSS. Results: Thirty-six (81.82%) cases were of the post-COVID status, and 8 cases were non-COVID status. Out of 36 post-COVID patients, 33 (91.67%) showed evidence of invasive mucormycosis and of 8 non-COVIDpatients, 7 had evidence of mucormycosis (odds ratio = 1.57). Out of the total diagnosed cases of mucormycosis, 21 (52.5%) patients were known cases of diabetes mellitus (DM), and 7 (17.5%) cases of newly diagnosed hyperglycemia. Thirty (75%) patients out of 40 had some form of immunocompromised state. This shows statistically significant association of DM and immunocompromised state with the occurrence of mucormycosis in post-COVID patients (chi square value2 = 6.891, P value = 0.008). Twenty-five patients had the history of steroid use during the treatment of COVID-19. Conclusions: The infection with COVID-19 definitely increases the odds of contracting mucormycosis, but most of the cases had diabetes mellitus. So, it is possible that COVID-19 virus predisposes individuals to invasive fungal infection by precipitating DM.

Prognostic significance of eye changes in cerebral malaria.

AIMS: Eye in Plasmodium falciparum malaria are described by various workers all over the world but its prognostic significance is not clear because of conflicting observation by different authors from different regions. No such study is available on Indian adult patients of cerebral malaria. So we want to describe our observations on various eye abnormalities in these patients and study its prognostic significance. METHODOLOGY: Two hundred and fourteen adult (> 14 years) patients of strictly defined cerebral malaria admitted in classified malaria ward in this tertiary level health care station were studies. Detailed ophthalmoscopic examination was done through dilated pupils at the time of admission, daily thereafter, at the time of discharge and at weekly intervals in those with persistent changes at the time of discharge. RESULT: Retinal haemorrhage was found in 25 (11.68%) patients, papilloedema in 17 (7.94%), blurring of disc margins in 25 (11.68%), retinal oedema in six (2.8%), disc pallor in five (2.33%), vitreous haemorrhage and hard exudate in one (0.46%) each and subconjunctival haemorrhage in six (2.8%) patients. The mortality associated with individual finding was not statistically significant except disc pallor. CONCLUSION: None of the above finding except disc pallor (p < 0.05) was associated with statistically significant mortality (p > 0.05); whereas any of the fundus findings as a whole was related to statistically significant mortality (p < 0.05).

Synthetic peptides: a modern approach to vaccination.

For induction of humoral or cell-mediated immunity, development of synthetic peptide vaccines present a novel approach and a better alternative to conventional vaccines. Construction of synthetic peptides that mimic antigenic sites is the basis of this approach. In this article various methodologies involved in the peptide synthesis are discussed. This is followed by a discussion on the strategies involved in rendering poor or non-immunogenic peptides immunogenic. These include coupling to large carrier proteins, polymeric presentation and incorporation of an identified Th cell epitope into the peptide.

Lipoproteins: their potential as endogenous target oriented novel drug delivery system.

Targeting of drugs to specific cellular sites is a major area of interest now a day. Various carrier systems, viz, liposomes, resealed erythrocytes, niosomes, immunomodulated nanospheres, etc. have been reported. A newer class of carrier system based on endogenous origin has been identified as lipoproteins. The present review discusses the classification, biological fate and targeting potentials of such system when the drug is encapsulated. Furthermore their is a brief discussion about the approaches utilised for their more specific targeting (acyloglycoprotein receptor etc.). Some of the observed drawbacks of such systems could be combated with the use of synthetically prepared lipoproteins named as SMBV (supramolecular biovectors) have also been discussed. Various biomedical potential of these lipoproteins in the delivery of drug to neoplastic cell lines, viral and parasitic infections in liver have also been highlighted.

Metallic ions as negative modifiers of cholinesterase.

Copper and Zinc have been found to be potent inhibitors of pseudo-cholinesterase of human plasma and true-cholinesterase of erythrocytes and rat brain.