THE SPREAD OF ‘‘BLACK FUNGUS’’ IN INDIA-AN EPIDEMIC

2021 ◽  
pp. 20-21
Author(s):  
Atiya imteyaz
Keyword(s):  
Mortality Rate ◽  
Major Trauma ◽  
Developed Countries ◽  
Severe Neutropenia ◽  
Intravenous Drug Use ◽  
Pulmonary Infections ◽  
Gastrointestinal Infections ◽  
Uncontrolled Diabetes ◽  
Life Threatening ◽  
Overall Mortality

Mucormycosis is a life-threatening infection caused by fungi of the order Mucorales. Recent reclassication has abolished the order Zygomycetes and placed the order Mucorales in the subphylum Mucormycotina . Therefore, we refer to infection caused by Mucorales as mucormycosis, rather than zygomycosis. This disease is increasingly recognized in recently developed countries, such as India, mainly in patients with uncontrolled diabetes or trauma and also seen in the patients who just recovered from the COVID-19. The most important conditions predisposing to mucormycosis, according to various studies, include malignant hematological disease with or without stem cell transplantation, prolonged and severe neutropenia, poorly controlled diabetes mellitus with or without diabetic ketoacidosis, iron overload, major trauma, prolonged use of corticosteroids, illicit intravenous drug use, neonatal prematurity and malnourishment. The most common reported sites of invasive mucormycosis have been the sinuses (39%), lungs (24%), and skin (19%) . Dissemination developed in 23% of these cases. The overall mortality rate for the disease is 44% in diabetics, 35% in patients with no underlying conditions, and 66% in patients with malignancies. The mortality rate varied with the site of infection and host: 96% of patients with disseminated infections, 85% with gastrointestinal infections, and 76% with pulmonary infections died. In children, mucormycosis manifested as cutaneous, gastrointestinal, rhinocerebral, and pulmonary infections in 27%, 21%, 18%, and 16% of cases, respectively, in one study . The skin and gut are affected more frequently in children than in adults.

Cardiac rehabilitation of older patients

2003 ◽  
Vol 13 (3) ◽  
pp. 241-255 ◽  
Author(s):  
Robert West
Keyword(s):  
Major Trauma ◽  
Heart Surgery ◽  
Operative Mortality ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Open Heart Surgery ◽  
Developed Countries ◽  
The Other ◽  
Co Morbidity ◽  
Life Threatening

Rehabilitation is a necessary step in the process of recovery from most serious illness and from many clinical interventions. The nature of rehabilitation, and the form of any programme of rehabilitation provided to help patients with this process, depends greatly on patient, illness, treatment or intervention, co-morbidity and on the availability of appropriate services. Heart disease is the leading cause of death in most developed countries and acute myocardial infarction (MI) is a major cause of acute medical admissions to hospitals, and revascularization by coronary artery bypass graft surgery (CABG) is a leading surgical intervention. Both MI and CABG involve a day or more in intensive care followed by several days recuperation in hospital. There is a fairly obvious case for rehabilitation for patients surviving the truly life-threatening experience of MI (20% sudden deaths and a further 10% die within 24 hours of onset of pain), and for patients following the major ‘trauma’ of open heart surgery (operative mortality about 1%). The specific needs of these two groups may differ because their experiences differ; one medical the other surgical, and, possibly more significantly, one unexpected, the other planned.

scholarly journals Mucormycosis involving paranasal sinuses in a post-COVID-19 patient with an uncontrolled diabetes-A rare presentation in an ongoing pandemic

2021 ◽  
Vol 6 (2) ◽  
pp. 137-140
Author(s):  
Sankalp Yadav ◽  
Novelesh Bachchan ◽  
Gautam Rawal ◽  
Pallawi Rai
Keyword(s):  
Mortality Rate ◽  
Fungal Infection ◽  
Opportunistic Infection ◽  
Paranasal Sinuses ◽  
Ethmoid Sinus ◽  
Rare Presentation ◽  
Uncontrolled Diabetes ◽  
Life Threatening ◽  
Second Wave ◽  
Indian Male

Mucormycosis (MCR) involving paranasal sinuses is a rare life-threatening opportunistic infection in immunocompromised individuals. In humans, MCR is considered as one of the most rapidly progressive lethal forms of fungal infection with a high mortality rate of 70–100%. During the second wave of COVID-19 in India, the cases of MCR have increased rapidly. We herein report a case of a 70-year-old Indian male with an uncontrolled diabetes diagnosed as maxillary and ethmoid sinus MCR.

scholarly journals Retrospective analysis of symptoms and outcomes of snakebite cases

2020 ◽  
Vol 11 (1) ◽  
pp. 1051-1054
Author(s):  
Ismail Y ◽  
Haja Nazeer Ahamed ◽  
Vijaya Vara Prasad M
Keyword(s):  
Mortality Rate ◽  
Retrospective Analysis ◽  
Tertiary Care ◽  
Time Lapse ◽  
Snake Bite ◽  
Care Hospital ◽  
Human Beings ◽  
General Medical Ward ◽  
Life Threatening ◽  
Overall Mortality

Usually, every part of the globe is found with snakes, varying with the species or variety of snakes found in a particular region. It is scientifically known that about 3000 types of snakes are prevalent in all parts of the globe. Among these 300, only 10% of the snakes are reportedly venomous, giving life-threatening risks in human beings.  Depending upon the snake group, neurotoxic or hemotoxic venom of the snake is manifested. Symptoms of swelling or without swelling at the site of the bite, flank bite marks, local pain are seen in moderate cases, and the severe cases may manifest with shock, renal failure, and/or coagulopathy. The retrospective data were collected from one tertiary care hospital in Nellore district, Andhra Pradesh, India.   A further retrospective analysis was carried out using snakebite victims or patients.  About 20 patients among these were excluded from the study based on incorrect labeling of snake bite.  Therefore, complete data for the study was collected from 72 patients for the study who were admitted into the general medical ward. When the duration time of the treatment is delayed, obviously, the snake bite becomes mortal in the case of the patient. This is because, like the time-lapse, the anti-venom action becomes ineffective. However, despite the above findings like clinical presentation, demographic characteristics, and timelines in both the groups. The overall mortality rate in the present study was reportedly 2%. It could be concluded from the study that by rapid administration of anti-venin in appropriate doses, the snakebite cases can be managed successfully. Thus, we suggest developing an inter-disciplinary approach to reducing the mortality rate of snakebite.

A Retrospective Study of Factors Influencing Survival Following Surgery for Gastric Dilatation-Volvulus Syndrome in 306 Dogs

2010 ◽  
Vol 46 (2) ◽  
pp. 97-102 ◽  
Author(s):  
George Mackenzie ◽  
Mathew Barnhart ◽  
Shawn Kennedy ◽  
William DeHoff ◽  
Eric Schertel
Keyword(s):  
Mortality Rate ◽  
Cardiac Arrhythmias ◽  
Gastric Resection ◽  
Postoperative Mortality ◽  
Mortality Rates ◽  
Gastric Dilatation ◽  
Factors Influencing ◽  
Threatening Condition ◽  
Life Threatening ◽  
Overall Mortality

Gastric dilatation-volvulus (GDV) is a life-threatening condition in dogs that has been associated with high mortality rates in previous studies. Factors were evaluated in this study for their influence on overall and postoperative mortality in 306 confirmed cases of GDV between 2000 and 2004. The overall mortality rate was 10%, and the postoperative mortality rate was 6.1%. The factor that was associated with a significant increase in overall mortality was the presence of preoperative cardiac arrhythmias. Factors that were associated with a significant increase in postoperative mortality were postoperative cardiac arrhythmias, splenectomy, or splenectomy with partial gastric resection. The factor that was associated with a significant decrease in the overall mortality rate was time from presentation to surgery. This study documents that certain factors continue to affect the overall and postoperative mortality rates associated with GDV, but these mortality rates have decreased compared to previously reported rates.

Brain-eating Amoebae Infection: Challenges and Opportunities in Chemotherapy

2019 ◽  
Vol 19 (12) ◽  
pp. 980-987 ◽  
Author(s):  
Mohammad Ridwane Mungroo ◽  
Ayaz Anwar ◽  
Naveed Ahmed Khan ◽  
Ruqaiyyah Siddiqui
Keyword(s):  
Mortality Rate ◽  
Free Living ◽  
Outdoor Activities ◽  
The Past ◽  
Free Living Amoeba ◽  
Challenges And Opportunities ◽  
Life Threatening ◽  
The Central Nervous System ◽  
Living Nature ◽  
Treatment And Diagnosis

Pathogenic free-living amoeba are known to cause a devastating infection of the central nervous system and are often referred to as “brain-eating amoebae”. The mortality rate of more than 90% and free-living nature of these amoebae is a cause for concern. It is distressing that the mortality rate has remained the same over the past few decades, highlighting the lack of interest by the pharmaceutical industry. With the threat of global warming and increased outdoor activities of public, there is a need for renewed interest in identifying potential anti-amoebic compounds for successful prognosis. Here, we discuss the available chemotherapeutic options and opportunities for potential strategies in the treatment and diagnosis of these life-threatening infections.

scholarly journals Trauma-Induced Coagulopathy: Overview of an Emerging Medical Problem from Pathophysiology to Outcomes

Medicines ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 16
Author(s):  
Gabriele Savioli ◽  
Iride Francesca Ceresa ◽  
Luca Caneva ◽  
Sebastiano Gerosa ◽  
Giovanni Ricevuti
Keyword(s):  
Major Trauma ◽  
Management Strategies ◽  
Medical Problem ◽  
Current Evidence ◽  
Potential Drug ◽  
The Past ◽  
Trauma Induced Coagulopathy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Trauma Mortality

Coagulopathy induced by major trauma is common, affecting approximately one-third of patients after trauma. It develops independently of iatrogenic, hypothermic, and dilutive causes (such as iatrogenic cause in case of fluid administration), which instead have a pejorative aspect on coagulopathy. Notwithstanding the continuous research conducted over the past decade on Trauma-Induced Coagulopathy (TIC), it remains a life-threatening condition with a significant impact on trauma mortality. We reviewed the current evidence regarding TIC diagnosis and pathophysiological mechanisms and summarized the different iterations of optimal TIC management strategies among which product resuscitation, potential drug administrations, and hemostatis-focused approaches. We have identified areas of ongoing investigation and controversy in TIC management.

scholarly journals Prospective cohort study of mortality in very low birthweight infants in a single centre in the Eastern Cape province, South Africa

2021 ◽  
Vol 5 (1) ◽  
pp. e000918
Author(s):  
Isabel A Michaelis ◽  
Ingeborg Krägeloh-Mann ◽  
Ncomeka Manyisane ◽  
Mikateko C Mazinu ◽  
Esme R Jordaan
Keyword(s):  
South Africa ◽  
Cohort Study ◽  
Birth Weight ◽  
Mortality Rate ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Low Birthweight ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Overall Mortality

BackgroundNeonatal mortality is a major contributor worldwide to the number of deaths in children under 5 years of age. The primary objective of this study was to assess the overall mortality rate of babies with a birth weight equal or below 1500 g in a neonatal unit at a tertiary hospital in the Eastern Cape Province, South Africa. Furthermore, different maternal-related and infant-related factors for higher mortality were analysed.MethodsThis is a prospective cohort study which included infants admitted to the neonatal wards of the hospital within their first 24 hours of life and with a birth weight equal to or below 1500 g. Mothers who consented answered a questionnaire to identify factors for mortality.Results173 very low birth weight (VLBW) infants were recruited in the neonatal department between November 2017 and December 2018, of whom 55 died (overall mortality rate 32.0%). Twenty-three of the 44 infants (53,5%) with a birth weight below 1000 g died during the admission. One hundred and sixty-one mothers completed the questionnaire and 45 of their babies died.Main factors associated with mortality were lower gestational age and lower birth weight. Need for ventilator support and sepsis were associated with higher mortality, as were maternal factors such as HIV infection and age below 20 years.ConclusionThis prospective study looked at survival of VLBW babies in an underprivileged part of the Eastern Cape of South Africa. Compared with other public urban hospitals in the country, the survival rate remains unacceptably low. Further research is required to find the associated causes and appropriate ways to address these.

scholarly journals All-cause mortality and location of death in patients with established cardiovascular disease before, during, and after the COVID-19 lockdown: a Danish Nationwide Cohort Study

2021 ◽  
Author(s):  
Jawad H Butt ◽  
Emil L Fosbøl ◽  
Thomas A Gerds ◽  
Charlotte Andersson ◽  
Kristian Kragholm ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Location Of Death ◽  
All Cause Mortality ◽  
History Of ◽  
Adjusted Incidence Rate ◽  
Artery Disease ◽  
Adjusted Incidence ◽  
Overall Mortality

Abstract Background On 13 March 2020, the Danish authorities imposed extensive nationwide lockdown measures to prevent the spread of the coronavirus disease 2019 (COVID-19) and reallocated limited healthcare resources. We investigated mortality rates, overall and according to location, in patients with established cardiovascular disease before, during, and after these lockdown measures. Methods and results Using Danish nationwide registries, we identified a dynamic cohort comprising all Danish citizens with cardiovascular disease (i.e. a history of ischaemic heart disease, ischaemic stroke, heart failure, atrial fibrillation, or peripheral artery disease) alive on 2 January 2019 and 2020. The cohort was followed from 2 January 2019/2020 until death or 16/15 October 2019/2020. The cohort comprised 340 392 and 347 136 patients with cardiovascular disease in 2019 and 2020, respectively. The overall, in-hospital, and out-of-hospital mortality rate in 2020 before lockdown was significantly lower compared with the same period in 2019 [adjusted incidence rate ratio (IRR) 0.91, 95% confidence interval (CI) CI 0.87–0.95; IRR 0.95, 95% CI 0.89–1.02; and IRR 0.87, 95% CI 0.83–0.93, respectively]. The overall mortality rate during and after lockdown was not significantly different compared with the same period in 2019 (IRR 0.99, 95% CI 0.97–1.02). However, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during and after lockdown compared with the same period in 2019 (in-hospital, IRR 0.92, 95% CI 0.88–0.96; out-of-hospital, IRR 1.04, 95% CI1.01–1.08). These trends were consistent irrespective of sex and age. Conclusions Among patients with established cardiovascular disease, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during lockdown compared with the same period in the preceding year, irrespective of age and sex.

Laparotomy for Abdominal Stab Wound With Combined Omental and Organ Evisceration: 10-Year Experience From a Major Trauma Centre in South Africa

2021 ◽  
pp. 000313482110318
Author(s):  
Victor Kong ◽  
Cynthia Cheung ◽  
Nigel Rajaretnam ◽  
Rohit Sarvepalli ◽  
William Xu ◽  
...  
Keyword(s):  
South Africa ◽  
Small Bowel ◽  
Large Bowel ◽  
Major Trauma ◽  
Stab Wound ◽  
Length Of Hospital Stay ◽  
Trauma Centre ◽  
Major Trauma Centre ◽  
The Mean ◽  
Overall Mortality

Introduction Combined omental and organ evisceration following anterior abdominal stab wound (SW) is uncommon and there is a paucity of literature describing the management and spectrum of injuries encountered at laparotomy. Methods A retrospective study was undertaken on all patients who presented with anterior abdominal SW involving combined omental and organ evisceration who underwent laparotomy over a 10-year period from January 2008 to January 2018 at a major trauma centre in South Africa. Results A total of 61 patients were eligible for inclusion and all underwent laparotomy: 87% male, mean age: 29 years. Ninety-two percent (56/61) had a positive laparotomy whilst 8% (5/61) underwent a negative procedure. Of the 56 positive laparotomies, 91% (51/56) were considered therapeutic and 9% (5/56) were non-therapeutic. In addition to omental evisceration, 59% (36/61) had eviscerated small bowel, 28% (17/61) had eviscerated colon and 13% (8/61) had eviscerated stomach. A total of 92 organ injuries were identified. The most commonly injured organs were small bowel, large bowel and stomach. The overall complication rate was 11%. Twelve percent (7/61) required intensive care unit admission. The mean length of hospital stay was 9 days. The overall mortality rate for all 61 patients was 2%. Conclusions The presence of combined omental and organ evisceration following abdominal SW mandates laparotomy. The small bowel, large bowel and stomach were the most commonly injured organs in this setting.

scholarly journals Novel HAX1 Gene Mutation in a Vietnamese Boy with Severe Congenital Neutropenia

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Tham Thi Tran ◽  
Quang Van Vu ◽  
Taizo Wada ◽  
Akihiro Yachie ◽  
Huong Le Thi Minh ◽  
...  
Keyword(s):  
Early Onset ◽  
Bacterial Infections ◽  
Complete Blood Count ◽  
Hereditary Diseases ◽  
Severe Neutropenia ◽  
Sequencing Analysis ◽  
Severe Congenital Neutropenia ◽  
Congenital Neutropenia ◽  
Direct Dna Sequencing ◽  
Life Threatening

Severe congenital neutropenia (SCN) is a rare disease that involves a heterogeneous group of hereditary diseases. Mutations in the HAX1 gene can cause an autosomal recessive form of SCN-characterized low blood neutrophil count from birth, increased susceptibility to recurrent and life-threatening infections, and preleukemia predisposition. A 7-year-old boy was admitted due to life-threatening infections, mental retardation, and severe neutropenia. He had early-onset bacterial infections, and his serial complete blood count showed persistent severe neutropenia. One older sister and one older brother of the patient died at the age of 6 months and 5 months, respectively, because of severe infection. Bone marrow analysis revealed a maturation arrest at the promyelocyte/myelocyte stage with few mature neutrophils. In direct DNA sequencing analysis, we found a novel homozygous frameshift mutation (c.423_424insG, p.Gly143fs) in the HAX1 gene, confirming the diagnosis of SCN. The patient was successfully treated with granulocyte colony-stimulating factor (G-CSF) and antibiotics. A child with early-onset recurrent infections and neutropenia should be considered to be affected with SCN. Genetic analysis is useful to confirm diagnosis. Timely diagnosis and suitable treatment with G-CSF and antibiotics are important to prevent further complication.

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