Maxillary necrosis by Mucormycosis: A Case Report

A 50-year-old woman with type 2 diabetes was referred to the hospital with a 4-week history of a facial redness that proceeded to significant midface ulceration and bilateral vision loss. Her nasal bridge was completely collapsed, she had naso-palatal ulceration with black eschars on the mucosa, and her fasting blood sugar was significantly increased. Her blood sugar was controlled with soluble insulin through sliding scale, and surgical debridement was performed, which revealed fungal hyphae on histo-pathological assessment. Ketoconazole, an antifungal drug, was commenced immediately. She progressed slowly but steadily after that and her wound became clear with fresh granulation tissue. Keywords: Mucormycosis, Uncontrolled diabetic mellitus

Download Full-text

Post-COVID rhinocerebral mucormycosis: an otolaryngologists nightmare

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212450 ◽

2021 ◽

Vol 7 (7) ◽

pp. 1144

Author(s):

Samir V. Joshi ◽

Nimita Dubey ◽

Rajesh R. Havaldar ◽

Amish Wakhlu

Keyword(s):

Vision Loss ◽

Fungal Infections ◽

Tertiary Care ◽

Positive Outcome ◽

Rhinocerebral Mucormycosis ◽

Facial Swelling ◽

Life Threatening ◽

History Of ◽

High Index Of Suspicion

Background: Rhinocerebral mucormycosis which was considered to be a rare occurrence in the pre-COVID era is currently emerging as a life-threatening disease with seemingly poor prognosis in post COVID recovered patients. Prompt diagnosis with urgent surgical and medical management is vital to a positive outcome.Methods: A retrospective observational study and analysis was done among patients of biopsy proven mucormycosis with preceding history of COVID 19 disease between March 2021 to April 2021 in a tertiary care state run hospital at Pune coinciding with the sudden surge and second COVID 19 wave.Results: 20 0ut of 23 patients were having a history of type 2 diabetes mellitus for a mean duration of 4±3.5 years. The most common presenting complaint was unilateral facial swelling, periorbital pain, swelling and oedema in 18 out of 23 patients. All patients had COVID infection within the last one month of presentation with mean duration of 18±8.4 days. Out of 23 patients 16 survived while 19 patients had permanent vision loss and ophthalmoplegia.Conclusions: Establishing the possibility of invasive secondary fungal infections in patients with history of COVID-19 infection especially in patients with pre-existing risk factors should raise high index of suspicion. Prompt early diagnosis and treatment should be started to reduce morbidity and mortality.

Download Full-text

Natural History of Diabetic Retinopathy Through Retrospective Analysis in Type 2 Diabetic Patients—An Exploratory Study

Frontiers in Public Health ◽

10.3389/fpubh.2021.791378 ◽

2021 ◽

Vol 9 ◽

Author(s):

Mehak Gupta ◽

Amarjeet Singh ◽

Mona Duggal ◽

Ramandeep Singh ◽

Sanjay Bhadada ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Natural History ◽

Medical Records ◽

Vision Loss ◽

Adult Population ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

History Of ◽

Type 2 Diabetic

Background and Aims: Diabetic retinopathy is the most common diabetes-associated microvascular complication and is among the leading causes of vision loss or blindness in the adult population. The present study is a retrospective study that reported the natural history of diabetic retinopathy.Methods: Retrospective medical records of 170 patients aged > 20 years with a confirmed complication of diabetic retinopathy were recruited into the present study. A questionnaire was also sent to each subject for gathering their experiences, and verification was done by the attending medical physicians. The questionnaire was answered by all recruited patients.Results: The results showed that 23 (13.5%) subjects have a family history of diabetic retinopathy with 10 (5.9%) having mild NPDR, 63 (37.1%) with moderate NPDR, 60 (25.3%) have severe NPDR while 37 (21.8%) have PDR complications. The presence of co-morbidities was found in 139 (81.8%) subjects. Patients with PDR reported a significantly longer duration of diabetes mellitus with worse glycemic control.Conclusions: The study revealed and concluded that adherence to the prescribed management regimen is important, for which patient education was the key which was lacking.

Download Full-text

Reactivation of Acute Retinal Necrosis following SARS-CoV-2 Infection

Case Reports in Ophthalmological Medicine ◽

10.1155/2021/7336488 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Monica P. Gonzalez ◽

Radames Rios ◽

Mariella Pappaterra ◽

Miguel Hernandez ◽

Allison Toledo ◽

...

Keyword(s):

Vision Loss ◽

Acute Retinal Necrosis ◽

Pcr Analysis ◽

Prior History ◽

Ophthalmological Examination ◽

History Of ◽

Polymerase Chain ◽

Simplex Virus ◽

The Right

Purpose. To report on a case of reactivation of acute retinal necrosis following SARS-CoV-2 infection. Methods. Observational case report. Observations. A 32-year-old female with a distant history of left retinal detachment secondary to necrotizing herpetic retinitis complained of right-eye vision loss, pain, redness, and photophobia. An ophthalmological examination revealed findings consistent with acute retinal necrosis of the right eye. A polymerase chain reaction (PCR) analysis of the right vitreous was positive for herpes simplex virus type 2 (HSV-2). A coronavirus disease 2019 (COVID-19) screening test using reverse transcriptase- (RT-) PCR was positive for SARS-CoV-2 RNA. Conclusions. Our case suggests that COVID-19 may cause a latent HSV infection to reactivate, causing contralateral involvement in patients with a prior history of HSV-associated acute retinal necrosis.

Download Full-text

Control of Post Prandial Blood Sugar Among the Treatment Patterns for Type 2 Diabetic Mellitus: A Retrospective Study

Indian Journal of Pharmacy Practice ◽

10.5530/ijopp.9.2.13 ◽

2016 ◽

Vol 9 (2) ◽

pp. 136-138

Author(s):

Malarkodi Velraj ◽

G. Ragesh ◽

Poripiraddy Satya Prasad

Keyword(s):

Retrospective Study ◽

Blood Sugar ◽

Treatment Patterns ◽

Diabetic Mellitus ◽

Type 2 Diabetic Mellitus ◽

Type 2 Diabetic

Download Full-text

Improvements in visual acuity and macular morphology following cessation of anti-estrogen drugs in a patient with anti-estrogen maculopathy resembling macular telangiectasia type 2: a pathogenic hypothesis

BMC Ophthalmology ◽

10.1186/s12886-019-1280-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Akihiro Shinkai ◽

Wataru Saito ◽

Yuki Hashimoto ◽

Susumu Ishida

Keyword(s):

Visual Acuity ◽

Vision Loss ◽

Pigment Epithelium ◽

Fundus Autofluorescence ◽

Retinal Pigment ◽

Macular Telangiectasia ◽

History Of ◽

Macular Telangiectasia Type 2 ◽

The Relationship

Abstract Background The relationship between anti-estrogen drugs and macular telangiectasia type 2 (MacTel-2) remains unknown. Here we report a case with anti-estrogen maculopathy resembling MacTel-2 with improved visual function and macular morphology following cessation of anti-estrogen drugs. Case presentation A 53-year-old woman presented with a 5-month history of central vision loss and anorthopia in both eyes. She had received oral tamoxifen followed by toremifene for 69 months. Funduscopy, fluorescein angiography, and optical coherence tomography (OCT) revealed MacTel-2-like findings OU. Fundus autofluorescence (FAF) showed hyper-autofluorescence at the fovea OU. Visual acuity, macular morphology on OCT, and FAF findings gradually improved after cessation of anti-estrogen drugs. Conclusions In the present case, visual acuity, macular morphology, and impairment of the retinal pigment epithelium (RPE) improved following cessation of anti-estrogen drugs, suggesting the relationship between retinal toxicity of anti-estrogen drugs and the development of MacTel-2-like findings. From these results and the previous observations, toxicity of both photoreceptor and RPE cells caused by anti-estrogen drugs may contribute to the development of anti-estrogen maculopathy similar to MacTel-2.

Download Full-text

Study of prevalence and determinants of peripheral neuropathy in patients with type 2 diabetes mellitus

MedPulse International Journal of Physiology ◽

10.26611/1031832 ◽

2021 ◽

Vol 18 (3) ◽

pp. 10-14

Author(s):

S Bethiun ◽

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Peripheral Neuropathy ◽

Blood Sugar ◽

Fasting Blood Sugar ◽

Age Group ◽

Duration Of Diabetes ◽

History Of

Background: India is witnessing a depressing situation due to escalating incidence and prevalence of type 2 diabetes mellitus (T2DM) and its inevitable outcomes of cardiovascular diseases (CVD), diabetic neuropathy, nephropathy and retinopathy. Present study was aimed to investigate peripheral neuropathy in adult patients with type 2 diabetes. Material and Methods: Present study was hospital based, prospective, observational study conducted in subjects recruited from the diabetes OPD of both gender ≥ 30 years, known case of type 2 diabetes mellitus. The screening for DPN was conducted using the Michigan Neuropathy Screening Instrument (MNSI). Results: In present study, 256 subjects satisfying study criteria were considered for study. Most of patients were from 51-65 years age group (39.8%) followed by 31-50 years age group (37.1%). Male subjects (54.3%) were more than females (45.7%). Mean duration of type 2 diabetes mellites was 10.6 ± 6.3 years. Mean HbA1c was 9.3 ± 2.8% and 65.6% had HbA1c≥7%. Common high risk factors were hypertension (52.3%), alcoholic > 60 mg/day (30.5%), BMI > 30kg/m2 (26.6%), smoking habits >1 pack/day (18.0 %), history of peripheral artery disease (12.5 %) and history of prior ulcer (12.1%). Prevalence of peripheral neuropathy in subjects with type 2 diabetes mellitus in present study was 35.2%, calculated as per reduced perception/absent monofilament test. Vibration perception test was absent in 22.7 % subjects and ankle reflex was absent in 13.3 % subjects. Age, duration of diabetes, fasting blood sugar, BMI, HbA1c ≥ 7 % and alcoholic (> 60 mg/day) were statistically significant in subjects of type 2 diabetes mellitus with peripheral neuropathy and difference was statistically significant. Conclusion: Diabetic peripheral neuropathy was significantly and positively associated with age, duration of diabetes, fasting blood sugar, BMI, HbA1c ≥ 7 % and alcoholic (> 60 mg/day). Regular screening of patients with diabetes mellitus for peripheral neuropathy may be recommended for early diagnosis and treatment.

Download Full-text

349 COVID Induced Acute Ischaemic Limb

British Journal of Surgery ◽

10.1093/bjs/znab259.285 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

B Shah ◽

M Kedrzycki

Keyword(s):

Multiple Organ ◽

Hypercoagulable State ◽

Organ Support ◽

Therapeutic Anticoagulation ◽

Life Threatening ◽

History Of ◽

Sliding Scale ◽

The Right ◽

Diabetes And Obesity

Abstract The coronavirus pandemic has overwhelmed healthcare systems worldwide, with more than 40 million affected and 1 million deaths. In addition to the typical symptoms, less clinically obvious was the underlying hypercoagulable state, termed COVID-19 associated coagulopathy (CAC). The exact mechanism of CAC is unknown, but it is suspected to involve all three aspects of Virchow’s Triad: endothelial injury, stasis, and a hypercoagulable state. Here we report the case of a woman in her 60’s who was admitted with COVID-19 and developed CAC with subsequent complications. She presented with a 3-day history of fevers, severe shortness of breath, and cough. Past medical history was significant for hypertension, poorly controlled insulin dependant diabetes, and obesity. She was admitted with COVID induced type 2 respiratory failure (pO2 of 5.5 on 15L), DKA (ketones 2.1), AKI (Cr 163), and a hypercoagulable state (D-dimer >20 000). She was intubated and commenced on an insulin sliding scale, therapeutic anticoagulation, and antibiotics. On day 2 she became anuric, with CT-angio demonstrating thrombus extending from renal arteries down to the right popliteal artery. She underwent an embolectomy and 4 compartment fasciotomy and was started on renal replacement therapy. Unfortunately, her leg was not deemed viable, and due to persistent hyperkalaemia required amputation 2 days later. She continued to deteriorate despite maximal multiple organ support and was palliated 15 days later. CAC can have life-threatening sequelae, and patients with COVID-19 infection should be commenced on anticoagulation upon diagnosis.

Download Full-text

HUBUNGAN FAKTOR RIWAYAT DIABETES MELLITUS DAN KADAR GULA DARAH PUASA DENGAN KEJADIAN DIABETES MELLITUS TIPE 2 PADA PASIEN USIA 25-64 TAHUN DI PUSKESMAS KENDAL KEREP KOTA MALANG

Preventia : The Indonesian Journal of Public Health ◽

10.17977/um044v4i1p56-62 ◽

2019 ◽

Vol 4 (1) ◽

pp. 56

Author(s):

Rara Warih Gayatri

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Blood Sugar ◽

Fasting Blood Sugar ◽

Cross Sectional ◽

History Of ◽

Sugar Levels ◽

Quota Sampling ◽

Diabetes Melitus

Abstract: Diabetes mellitus (DM) is one of the systemic diseases that manifests in the oral cavity. One effort to prevent type 2 diabetes is through surveillance activities to determine the associated risk factors. The purpose of this study was to determine the relationship of risk factors for history of diabetes mellitus and fasting blood sugar levels with the incidence of type 2 diabetes mellitus at Puskesmas Kendal Kerep in Malang City. This study used a quantitative descriptive method with cross-sectional design and was conducted at the Puskesmas Kendal Kerep in Malang City, April 2017. The sampling method used was the quota sampling method with the measured variables: the prevalence of diabetes mellitus, a history of diabetes mellitus and levels fasting blood sugar. Data collection techniques used were interview and measurement of fasting blood sugar levels. The research instrument used were Glucko Blood Meter devices and questionnaires. Data processing includes the process of editing, coding, scoring, data entry and cleaning. Data analysis used were univariate and bivariate. The conclusion of the study is that there is a significant relationship between history of Diabetes Mellitus and GDP levels with type 2 DM.Keywords: History of Diabetes Mellitus, Fasting Blood Sugar Levels, Type 2 Diabetes MellitusAbstrak: Diabetes Melitus (DM) merupakan salah satu penyakit sistemik yang bermanifestasi dalam rongga mulut. Salah satu upaya untuk mencegah DM tipe 2 adalah melalui kegiatan surveilans untuk mengetahui faktor resiko yang terkait. Tujuan penelitian ini untuk mengetahui hubungan faktor resiko riwayat diabetes mellitus dan kadar gula darah puasa dengan kejadian diabetes mellitus tipe 2 di Puskesmas Kendal Kerep Kota Malang. Penelitian ini menggunakan metode deskriptif kuantitatif dengan desain potong lintang (cross-sectional) dan dilakukan di Puskesmas Kendal Kerep Kota Malang, Bulan April 2017. Metode sampling yang digunakan merupakan metode quota sampling dengan variable yang diukur adalah kejaidan diabetes mellitus, riwayat diabetes mellitus dan kadar gula darah puasa. Teknik pengumpulan data menggunakan wawancara dan pemeriksaan kadar gula darah puasa. Instrumen penelitian menggunkan kuesioner dan alat Glucko Blood Meter. Pengolahan data yang dilakukan meliputi proses editing, coding, scoring, entry data dan cleaning. Analisa data dilakukan dengan analisis statistic univariat dan bivariat. Kesimpulan penelitian adalah terdapat hubungan yang signifikan antara riwayat DM dan kadar GDP dengan DM tipe 2. Kata kunci: Riwayat Diabetes Melitus, Kadar Gula Darah Puasa, Diabetes Mellitus Tipe 2

Download Full-text

ESTIMATION OF SERUM FERRITIN LEVELS IN TYPE 2 DIABETIC PATIENTS AND ITS RELATION WITH HbA1C LEVEL.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.456 ◽

2019 ◽

Vol 3 (8) ◽

Author(s):

Shah Namrata Vinubhai ◽

Pardeep Agarwal ◽

Bushra Fiza ◽

Ramkishan Jat

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Sugar ◽

Serum Ferritin ◽

Inflammatory Marker ◽

Control Group ◽

Diabetic Patients ◽

Positive Correlation

Background: Serum ferritin is known as an index for body iron stores also as an inflammatory marker and it is influenced by several disease. We were looking for a correlation between HbA1c and S. Ferritin in type 2 DM. Methodology: The present study a total of 150 participants were enrolled of which 100 were confirmed cases of Type 2 Diabetes Mellitus and rest 50 age and sex matched healthy subjects constituted the control group. All were screened for HbA1c, Fasting blood sugar, Post prandial blood sugar and S.Ferritin. Results: A highly significant variation and positive correlation was observed with respect to S.Ferritin and HbA1c levels. Mean S.Ferritin was high in the subgroup with poor glycemic control. Conclusion: The fasting, post prandial sugar levels, HbA1c and S.Ferritin were significantly higher in the diabetic subjects. This study shows a positive correlation between HbA1c and S. Ferritin levels. So we can conclude that in diabetic patients S. Ferritin may serve as an independent marker of poor glycemic and metabolic control. Keywords: Serum ferritin, Type 2 Diabetes Mellitus, HbA1c.

Download Full-text