RESUMO
Background: Chronic invasive Aspergillus sinusitis is an uncommon fungal infection that usually occurs in immunocompromized patients and rarely in healthy immunocompetent individuals. Chronic invasive Aspergillus sinusitis affecting the maxillary sinus may cause tremendous effects as maxillary bone destruction, displacement of teeth, bronchopulmonary infection and orbital involvement that may lead to proptosis and decreased vision. The maxillary sinus infection may result from direct inhalation of spores and not as a secondary infection from the oral cavity, endodontic treatment, or oro-antral fistulae. Case Summary: A 30 years old male patient presented to clinic complaning of right sided facial swelling and nasal obstruction. Clinical examination, Ortho-Pantomogram (OPG) and Cone Beam Computerized Tomography (CBCT) revealed a right maxillary sinus mass; laboratory investigations exclude presence of any systemic disease. Antrostomy of the lateral sinus wall (Caldwell-Luc surgery) was performed under local anesthesia to remove the sinus lining and mass. The mass was sent for histopathological investigation. The defect of bone was covered with the integrum periostium (the mucosal flap) without any bone graft or meshes. No antifungal drugs were prescribed. Post operative OPG and CBCT revealed complete removal of the lesion and clearance of the right side nasal air way. The histopathological examination found that the aspergillus Hyphae, fruits bodies and spores are present which confirmed the diagnosis. One year follow-up revealed that there is no recurrent infection; the drifted teeth realigned again and the maxillary sinus returns to its normal size. Conclusion: Early diagnosis and therapeutic intervention is the key to successful treatment of chronic invasive aspergillosis of the maxillary sinus. Surgical debridement can be done under local anesthesia without antifungal drug prescription and good prognosis was achieved.
RESUMO
The environmental factors may have an effect on the contents of the active materials in plants. Salinity is one of these factors that can have an influence through the calcium ion which competes with the Na+, which in turn, affects the manufacture of alkaloids present in the Datura stramunium. The buds of Datura stramunium have been cultured through addition of NaCl by using three successively different concentrations of 25, 50, and 100mM during a specific period of time of about 20 weeks. This has led to a rise in the content of K+ and a smaller content of Ca2+ in the leaves of plants subjected to salinity as well as a rise in the percentage of alkaloids in comparison with the control plants. The decrease in the ionic rate of K+/Na+ in the leaves of the plants subjected to salinity of less than one, namely, the decrease in the concentrations of K+ has led to an increase in the percentage of the alkaloid in the leaves of the plants subjected to the salinity in a specific rate in the concentration of 25mM. The more high concentration of salinity the more low calcium ions of Ca2+, and the ionic rate of Na+/K+ in the roots is lowest level due to the histological dying and loss of the young parts of the roots. The salinity in a low rate of 25mM can lead to an increase in the biologic metabolism and biologic manufacture of alkaloids in the leaves of the Datura stramunium in spite of the small decrease of the initial metabolism in the plants