MCI guidelines on publications for academic Promotions.

We read with interest the editorial by Aggarwal et al. 1 regarding the revised guidelines of the Medical Council of India (MCI) for publications for academic promotions.2 We agree with the authors that the new guidelines raise several important issues. The primary among them is the restriction of acceptable publications to original research with raw data. We do feel that systematic reviews, meta-analyses (including Cochrane reviews), brief communications (often because the journal will accept an original article in only this format), and case reports in journals with high impact factor should also be acceptable. The various indexing databases suggested do not include Science Citation Index and Indmed that are definitely more acceptable than Index Copernicus, which contains some journals of poor merit. We suggest that authorship in a high impact factor journal should be given more credit than one in a low impact factor journal. Finally, the first, second and last author should be given credit, rather than only the first and second. Issues of lack of adequate credit for the senior author in collaborative projects and ‘gift authorship’ are concerns with both extremes.

Unusual presentation of entomophthoromycosis.

Rhinoentomophthoromycosis caused by Conidiobolus sp commonly presents as a chronic granulomatous lesion that affects the rhinofacial subcutaneous tissue. We present an 18-year-old girl who presented with progressive bilateral proptosis and loss of vision since 2 weeks. Biopsy and fungal cultures confirmed diagnosis of Conidiobolus sp infection of the paranasal sinuses bilaterally with orbital extension and blindness. The clinical picture was complicated by the presence of sputum-positive cavitatory pulmonary tuberculosis, which was diagnosed at the same time. To our knowledge, this is the first such case to be reported from India. We also discuss the management of entomophthoromycosis. Despite many reports of success, there remains no consensus on the treatment of Conidiobolus infections of the nose and the paranasal sinuses with antifungal agents.

Non Hodgkins lymphoma of ethmoidal sinus with rhinoorbital myiasis.

A patient with primary non-hodgkins lymphoma of the paranasal sinuses presenting as rhinoorbital myiasis is reported. The myiasis causing species was identified as Chrysomia bezziana Villeneuve. This case demonstrates the extreme destruction caused by myiasis and the inadequacy of therapeutic options available in such patients.

Delayed effects of exposure to organophosphorus compounds.

In a group of 34 industrial workers, chronically exposed to organophosphorus (OP) compounds, serum pseudocholinesterase activity was depressed significantly in the exposed group as compared to the control group. There was a significantly higher incidence of peripheral neuropathy among the workers exposed to OP compounds, as compared to the control group. Mild to profound sensorineural hearing deficits were detected in both the exposed and control groups. As the pre-exposure hearing status of the workers was not known and since many other factors can also cause pathological changes in the cochlear nerve, a definite conclusion about the ototoxic nature of the OP compounds could not be drawn.