English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

This study was designed to through some light on mucormycosis infection, its stages, risk factors, presenting clinical features and to suggest early diagnostic techniques. A prospective explanatory study was carried out in the period between March 2011 to March 2016 for patients proved to be affected by this disease in Basrah General Hospital and different departments from all teaching hospitals in Basrah. The total studied patients were 32 with male to females ratio 2.2:1. The mostly affected age group was those between 51-60 years (16 patients, 50%). Seventeen patients (53.1%) belonged to stage I, nine (28.1%) to stage II, the remaining 6 patients(18.7%) to stage III. Majority of affected patients were immuno-compromised 27(84.3%). Diabetes mellitus was the main single risk factor (12 patients, 44.4%). The commonest recorded symptom was facial pain and numbness in 27 patients (84.3%), and the most common sign was nasal crustations and eschar in 28 patients(87.5) . This study concluded that surgeons should have an index of suspicion to be aware about this condition among the community, this can help in taking early preventive measures. Introduction ucormycosis is a term demonstrates a wide range of illnesses caused by infection commonly caused by Rhizopus species of fungi. In down sequence, other genera mucormycosis causing species includes Mucor, Cunninghamella, Apophysomyces, Absidia, Saksenaea, Rhizomucor, and several others. Most mucormycosis infections are extreme specially with risk factors, for example, diabetic ketoacidosis and neutropenia which are found in the majority of cases. Serious infection of the paranasal sinuses which may expand to the brain, is the widely recognized presentation. The infection happens following inward breath of contagious sporangiospores into the paranasal sinuses, and may then quickly extend into adjacent tissues. Once the attacking fungus germinated, it will grow posteriorly to invade the sphenoid sinus, laterally to the cavernous sinus to attack the orbits, inferiorly to attack the palate, or cranially to assault the brain. The fungus goes intracranialy all through either the orbital apex or ethmoid cribriform plate and this can lead to death. Occasionally, cerebral vascular invasion can lead to hematogenous distribution of the disease with or without progression of mycotic aneurysms. Mucormycosis ought to be considered as a medico-surgical crisis, antifungal therapy should be prescribed at any minor suggestion of the illness. Likewise, patients should have endoscopic assessment immediately so as to survey sinonasal structures and to take appropriate samples for histopathologic and microbiologic testing. Direct nasal smear and fungal cultures are helpful in the diagnosis, although negative results does not exclude the disease. Intraoperative frozen section is a specific M Rhinoorbitocerebral mucormycosis Ahmed AlAbbasi, Ali AbdilWahab, AbdilRazak Al Jezani, Haider Hashim & Duraid AlTemimi Bas J Surg, December, 23, 2017 10 and sensitive strategy for making a quick conclusion of rhinocerebral zygomycosis. Discovery of non-septate, branching (at 90 degrees) hyphae without granuloma formation in the biopsy establishes the diagnosis. Fine-needle aspiration cytology seems to be a practical option to tissue biopsy. Computed tomography(CT) (fig.1), or magnetic resonance imaging (MRI) is fundamental for staging the level of the condition as penetration of periantral fat planes may indicate the initial imaging proof of invasive fungal disease and should suggest the likelihood of invasive fungal sinusitis. sufficient debridement for removal of all devitalized tissue up to healthy or bleeding borders is vital, and multiple debridements may be necessary in few patients. Figure 1: Non-homogenous hyperdensity of right maxillary sinus The result of management is fine when the condition is anatomically constrained to the sinuses. In a study in India, the success rate of the treatment in stage I illness was 91%. The contention for careful debridement of all influenced tissue in patients with mucormycosis, depends on the capacity of the fungus to expand along the walls and blood vessels lumen which can bring about necrotising arteritis and ischemic necrosis of the tissues prompting poor distribution of systemically administered drugs. Patients and Methods This is a prospective cross-sectional analytical study performed in the period between March 2011 to March 2016, in Basrah General Hospital. The study included all patients proved to have mucormycosis histopathologically and were admitted or referred to Basrah General Hospital. A special questionnaire form was prepared by the authors and filled by house officer doctors of the ward. Initial investigations included complete blood counts, blood urea, serum creatinine, serum glucose. Rigid nasal endoscopy and biopsy was done for all patients and suspicious tissue was sent for histopathology. Computed tomography scanning of the paranansal sinuses, orbit, and brain, including axial and coronal sections was performed in all the cases to determine the extent of the disease. Magnetic resonance imaging was performed only for 9 patients suspected to have intracranial invasions (having neurological abnormalities) but only 6 of them had real intracranial invasion. The diagnosis was made in all cases by the presence of non-septate branching hyphae on histopathologic sections. The treatment was considered according to the currently suggested methods in textbooks. Following surgery (debridement) which was performed for all patients except six (4 has cerebral invasion and 2 refuse treatment), all patients were followed closely for disease progression and repeated debridement was done when necessary. Rhinoorbitocerebral mucormycosis Ahmed AlAbbasi, Ali AbdilWahab, AbdilRazak Al Jezani, Haider Hashim & Duraid AlTemimi Bas J Surg, December, 23, 2017 11 Results This study included thirty two patients with mucormycosis, 22 (68.75%) were males and 10(31.25) were females, male to female ratio was 2.2:1. Age distribution of patients with mucormycosis is shown in table I, the commonly affected age group was 51-60 years comprised 50% of the cases, while no patient was reported in ages between 11 to 40 years. Table I: Age and gender distribution of patients participating in this study. Age group Males Females Total

RHINO-ORBITO-CEREBRAL MUCORMYCOSIS IN BASRAH - IRAQ