Chronic renal failure presenting for the first time as pulmonary mucormycosis with a fatal outcome.

Pulmonary mucormycosis is an uncommon, but important, opportunistic fungal pneumonia which is often diagnosed late. Renal failure as the predominant presenting feature is not common in mucormycosis. Moreover, sudden, massive hemoptysis is not a usual complication. In this report we describe fatal pulmonary mucormycosis in a young patient with a previously undiagnosed chronic renal failure.

End-of-life care beliefs among Hindu physicians in the United States.

Several studies from the United States and Europe showed that physicians' religiosity is associated with their approach to end-of-life care beliefs. No such studies have focused exclusively on Hindu physicians practicing in the United States. A 34-item questionnaire was sent to 293 Hindu physicians in the United States. Most participants believed that their religious beliefs do not influence their practice of medicine and do not interfere with withdrawal of life support. The US practice of discussing end-of-life issues with the patient, rather than primarily with the family, seems to have been adopted by Hindu physicians practicing in the United States. It is likely that the ethical, cultural, and patient-centered environment of US health care has influenced the practice of end-of-life care by Hindu physicians in this country.

Acute tongue enlargement secondary to pharyngeal packing after tracheal intubation--a case report.

Acute tongue enlargement is a potentially lethal complication which is mostly reported in neurosurgical cases in sitting position. Very rarely it is reported in supine position. Most importantly it is reported at the end of the surgical procedures. Throat pack used along with tracheal intubation for protection of lower respiratory tract from soiling can lead to tongue enlargement due to obstruction of venous drainage. We are hereby reporting an interesting case of acute tongue enlargement in a patient scheduled for excision of brain tumor in supine position which occurred even before commencement of surgery due to excessive throat pack inserted for some nonessential indication. We thus recommend that throat pack should be used cautiously only when absolutely indicated. Otherwise it can lead to life threatening macroglossia.