The cross-sectional analytical study of COVID and post COVID mucormycosis in diabetic and non-diabetic patients and their outcomes

Background: Mucormycosis, a rare but serious fungal infection, has shown a concerning rise in incidence among COVID and post-COVID patients, with males constituting majority of cases. This study aimed to investigate the impact of diabetes mellitus (DM) on outcomes in patients with COVID and post-COVID mucormycosis. Given the known association between DM and increased susceptibility to infections, particularly fungal ones, understanding the role of DM in exacerbating mucormycosis outcomes is crucial for clinical management. Methods: A cross-sectional analytical study was conducted, involving a cohort of 50 patients with mucormycosis, equally divided into diabetic and non-diabetic groups. Data on morbidity, complications, hospitalization rates, and mortality were collected and compared between the two groups. Additionally, glycemic control status was assessed among diabetic patients to evaluate its impact on outcomes. Results: Among the 50 patients analyzed, diabetic individuals displayed significantly poorer outcomes compared to their non-diabetic counterparts. This included increased morbidity, complications, hospitalization rates, and mortality. Moreover, patients with uncontrolled DM exhibited the worst outcomes, highlighting the critical importance of managing glycemic control during mucormycosis treatment. Conclusions: The study underscores the necessity of vigilant monitoring and targeted interventions, particularly in diabetic individuals, to mitigate the adverse effects of mucormycosis in the context of COVID-19. Effective management of diabetes, especially glycemic control, is crucial for improving overall patient outcomes and reducing the burden of mucormycosis-related complications and mortality in both COVID and post-COVID scenarios. Further research is warranted to refine treatment protocols and optimize outcomes for this vulnerable population.

A comparative study of clinical profile of diabetic tuberculosis patients with non diabetic tuberculosis patients of outpatient department of tertiary healthcare centre

Background: The global increase in type 2 DM is recognized re-emerging risk and challenge to TB control in India. TB-T2D association is again at the frontline of risk factors for TB, with an estimated worldwide population attributable fraction of 34.5%. T2D not only increases TB risk 3-fold, but also TB treatment failure including death. And prognosis of diabetic tuberculosis patients as compared to non diabetic ones is poorer. Methods: An comparative analytical study was done in microbiologically confirmed 50 diabetic and 50 non diabetic TB patients registered in RNTCP OPD of tertiary healthcare hospital who were followed up for 3 months. Results: In our study we found that elderly (above 65 age group) male diabetic patients were affected more with tuberculosis as compared to young patients and data was statistically significant. Extrapulmonary involvement was seen more in diabetic patients as compared to non diabetic patients. Radiologically diabetic tuberculosis patient showed predominantly lower lobe of lung involvement as oppose to non diabetic tuberculosis patients who showed upper lobe of lung involvement and data was statistically significant. Outcomes like Multidrug Resistance and prolonged sputum positivity after intensive phase treatment was seen more with diabetic tuberculosis patients but this was not statistically significant. Conclusions: Early screening of TB patients for DM and vice versa and early initiation of treatment will prevent unfavourable outcomes of these patients.