Estimation of Serum Ferritin in Mucormycosis Patients and Prognostication Based on the Ferritin Value.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been implicated in a variety of vulnerable bacterial and fungal diseases. Mucormycosis is a life-threatening infection caused by fungi belonging to the class Zygomycetes and the order Mucorales. The aim of the present study is to evaluate the level of serum ferritin level in mucormycosis patients and to prognosticate them based on those values. MATERIALS AND METHODS: This prospective observational study was conducted in the Department of General Medicine, Mahatma Gandhi Memorial Government Hospital, Tiruchirappalli, in 50 diagnosed mucormycosis patients. RESULTS: During the study period, 44 had prior COVID-19 illness (post-COVID). Six patients had mucormycosis with no prior COVID-19 illness. Rhino-orbital involvement was found in 44 of the 50 cases, with three of them having cerebral extension. Forty-one cases recovered and were discharged, six cases remained sick and were hospitalized, and three died. The post-COVID patients (554.13 ± 371.60) have greater serum ferritin levels than non-COVID patients (259.95 ± 110.15), which are statistically significant.  Conclusion: Mucormycosis patients tend to have higher serum ferritin values, especially among non-survivors and sick patients than survivors. For a better chance of recovery and survival, early identification, surgical debridement, and antifungal medications are essential.

Small bowel obstruction- a surprise.

Trans - omental hernia is very rare, accounting to 1-4% of all internal hernias which is an unusual cause of small bowel obstruction. Here we present a case report of a small bowel obstruction in a female due to trans - omental hernia presenting with central abdominal pain, distension and bilious vomiting. She had no previous history of trauma, surgery. Plain X-ray abdomen erect showed multiple air fluid levels with dilated small bowel loops. Emergency laparotomy revealed a segment of congested small bowel loop (ileum) through a defect in greater omentum. On table the herniated bowel loop was reduced and the defect in greater omentum was closed primarily. There was no necessity for bowel resection as it regained normal colour after reduction. Postoperative period was uneventful with complete resolution of symptoms. This case is presented for its rarity and its importance in clinical differential diagnosis of acute abdomen due to small bowel obstruction.