Different types of mucormycosis: case series

Mucormycosis is the third invasive mycosis in order of importance after candidiasis and aspergillosis and is caused by fungi of the class Zygomycetes. The most important species causing Mucormycosis is Rhizopus arrhizus (oryzae). Identification of the agents responsible for mucormycosis is based on macroscopic and microscopic morphological criteria, carbohydrate assimilation and the maximum temperature compatible with its growth. The incidence of mucormycosis is approximately 1.7 cases per 1000 000 inhabitants per year. Clinical diagnosis of mucormycosis is difficult, and is often made at a late stage of the disease or post-mortem. We present here a series of five cases of different types of mucormycosis that were reported in our hospital till date. Of which three patients had good recovery and other two had a fatal outcome. Treatment of mucormycosis requires a rapid diagnosis, correction of predisposing factors, surgical resection or debridement as part of source control-and appropriate anti-fungal therapy. Liposomal amphotericin B is the drug of choice for this condition. The overall rate of mortality of mucormycosis is approximately 40%.

The quality of life of women volunteering as live-related kidney donors in India.

Background. Women outnumber men 6:1 as live-related donors in our renal transplant programme. Women donors in developing regions are often illiterate and unemployed. This study was done to assess the change in quality of life of women who donate kidneys. Methods. We prospectively studied 73 consecutive women volunteering as live-related kidney donors over a 6-month period using the World Health Organization Quality of Life Brief (WHO QoL Bref) Questionnaire and Hospital Anxiety and Depression Scale (HADS). Each woman was interviewed 2 weeks before and 6 months after kidney donation. Results. There was a significant improvement in all the domains, namely physical (p=0.0001), psychological (p<0.0001), social relationship (p=0.037) and environment (p<0.0001) of the WHO QoL Bref questionnaire. Donors who were mothers had a greater improvement in all 4 domains than donors with other relationships. There was a significant decrease in the depression score (p<0.0001), but no change in the anxiety scores (p=0.065) following kidney donation. All donors would donate again, if possible. Conclusion. In live-related women kidney donors, quality of life improves and depression scores decline after kidney donation.

Bleeding gums: duloxetine may be the cause.

Duloxetine is a newly introduced drug. It is being prescribed for the management of diabetic neuropathic pain and major depressive disorder. The most frequently observed adverse events with duloxetine are nausea, dry mouth and somnolence, constipation, diarrhea, decreased appetite, weight loss, feeling of fatigue, dizziness, somnolence, hypohidrosis, decreased libido and erectile dysfunction. One of the patients being prescribed the drug developed bleeding gums on being started with the drug which resolved on stopping it. We hereby report this case.

Neuroprotection of the nigrostriatal dopaminergic neurons by melatonin in hemiparkinsonium rat.

BACKGROUND & OBJECTIVES: Several lines of evidence point to a significant role of antioxidants in Parkinson's disease (PD). Few studies report that melatonin, a neurohormone, is one of the best physiological antioxidants. Review of literature indicates that none of the drugs so far studied for preventing the PD was found to be promising for use. Therefore in the present study the effect of neuroprotectory melatonin was tested against 6-hydroxydopamine (6-OHDA) neurotoxicity for striatal dopaminergic neurons in the rat. METHODS: Thirty animals were randomly divided into two groups. Animals of group 1 received saline (melatonin vehicle) daily 1 ml ip for seven days. Melatonin (500 mug/kg body weight dissolved in 1 ml saline ip) was administered in rats of group 2 for seven days. Then all animals of groups 1 and 2 were lesioned unilaterally with 8 mug 6-OHDA into the lateral striatum on 8(th) day. Various behaviour and histological tests were used to evaluate the neuroprotective effect of melatonin. RESULTS: Statistically significant difference in various behaviour tests was found between post lesion values of group 1 and group 2 (P<0.001 in apomorphine-induced rotational behaviour, staircase test (success rate), disengage time and P<0.05 in stepping test, initiation time, postural balance test). INTERPRETATION & CONCLUSION: Our results demonstrated that melatonin acted as an effective neuroprotective agent for striatal dopaminergic neurons in 6-OHDA lesioned rat model of Parkinson's disease.