ABSTRACT
A 40 year old female Nigerian with uncontrolled diabetes mellitus was referred to a teaching hospital with four week history of facial rash that progressed to extensive ulceration of the mid face and bilateral visual loss. She had complete nasal bridge collapse, nasopalatal fistula with black eschars on the mucosa and markedly elevated fasting blood sugar. Her blood glucose was controlled on insulin, She had surgical debridement and histopathological study done revealed fungi hyphae. Systemic antifungal (ketoconazole) was given. Subsequently, she made a slow but steady progress and her wound became clean with healthy granulation tissue. Rhinocerebral mucormycosis still remains a poorly understood disease with high mortality rate. Presently, the triad of clinician's awareness, prompt initiation of treatment and timely surgical intervention represent the effective way of managing the disease.
ABSTRACT
BACKGROUND: Allergic rhinitis (AR) and asthma are different manifestations of allergic disease of the airway. Both can exist together or as separate disease entity in an individual. However, it is not known if the coexistence of the two diseases can make asthmatic control difficult or not in the black population. OBJECTIVE: To determine the prevalence of allergic rhinitis in asthmatics and its effects on bronchial asthmatic control among adult Nigerians.. DESIGN: A prospective case-control study. SETTING: Lagos University Teaching Hospital, Lagos, Nigeria. SUBJECTS: Cases were 160 adult patients with confirmed bronchial asthma and controls were 160 subjects without bronchial asthma. METHODS: Structured questionnaire adapted from the European Community Respiratory Health Survey was applied. Allergic rhinitis was clinically diagnosed if watery rhinorrhea, nasal blockage, and excessive bout of sneezing, itching of eye, ear, nose or throat were present. RESULTS: Amongst the asthmatics, 133 (83%) had concomitant allergic rhinitis while 30 (19%) controls had allergic rhinitis(x(2)=137.81, p<0.001). Seventy eight (59%) cases with allergic rhinitis had uncontrolled asthma while 9 (33%) cases without allergic rhinitis had uncontrolled asthma (x(2) = 8.8731, p=0.012). CONCLUSION: The prevalence of allergic rhinitis among adult asthmatics was high and the co-existence of allergic rhinitis was significantly associated with poor asthmatic control.
