History Of Intake Research Articles

Changing Tides of Acute Interstitial Nephritis: A Retrospective Observational Study from South India.

The incidence of acute interstitial nephritis (AIN) has been increasing in recent years. The causes and outcomes of AIN have been changing with time and vary widely based on geographical region. A retrospective observational study was conducted in a tertiary care center. All (n = 6234) native kidney biopsies were reviewed from January 2016 to December 2021. All biopsy-proven AIN cases were included in the study. AIN associated with systemic diseases (such as SLE, Sjogren's, sarcoidosis, plasma cell dyscrasias), proliferative glomerulonephritis, and allograft biopsies were excluded. Among 6234 biopsies analyzed, there were 156 biopsy-proven AIN cases. The majority were in the 6th decade of life (24.4%) and males (80.8%). 50% of the patients had a history of drug intake, the most common being tenofovir (12.3%) followed by alternate forms of medications (10.3%). The majority (96.2%) presented with acute kidney injury (AKI). At the end of six months, 79.5% recovered completely, 19.2% progressed to chronic kidney disease. The presence of nephrotic range proteinuria at presentation was associated with progression to chronic kidney disease. AIN is an important cause of AKI, especially in the elderly population. Drugs are the most common cause, especially HAART follwed by alternate forms of medication. The presence of nephrotic range proteinuria was associated with increased risk of progression to chronic kidney disease.

Ceftazidime-induced immune hemolytic anemia: a case report

Drug-induced immune hemolytic anemia (DIIHA) is considered a rare condition. Nonsteroidal anti-inflammatory drugs and antineoplastic drugs are the main causes of DIIHA. An 86-year-old male patient with pulmonary infection was admitted to the 960^th Hospital of the PLA Joint Logistics Support Force. The patient was treated with ceftazidime in addition to supportive treatment. A history of antibiotics intake and clinical and laboratory hemolysis features were considered to be key bases for DIIHA diagnosis. Clinicians need to be aware of and accurately diagnose this rare complication caused by commonly prescribed drugs to stop the use of causative drugs in time, and therefore, to prevent serious and sometimes fatal consequences.

Role of Autoerythrocyte Sensitization Test in the Diagnosis of Recurrent Spontaneous Bruising.

Psychogenic purpura, also known as autoerythrocyte sensitization syndrome, is a rare condition which is characterized by spontaneous development of painful purpura, or ecchymoses. Skin lesions are usually preceded by stress and emotional trauma. It is usually a diagnosis of exclusion after ruling out history of trauma, drug intake and other bleeding disorders. Autoerythrocyte sensitization test (AEST) and a psychiatric evaluation helps in the diagnosis and treatment. To demonstrate the importance of AEST in diagnosing the patient of Gardner Diamond syndrome. Five suspected cases of autoerythrocyte sensitization syndrome underwent AEST after ruling out other causes of bleeding. Four out of five patients were positive for AEST while one patient was negative. Psychiatric complaints were present in three patients. One patient was lost to follow up. Rest all patients responded well to vitamin C supplementation. Autoerythrocyte sensitization syndrome is a rare disorder and is a diagnosis of exclusion, so a thorough workup of the patient to rule out common causes of bruising is essential. A high index of suspicion on the clinician's part and a simple OPD-based AEST may help in the diagnosis. Psychiatric consultation is important to find out the stress factor and timely management.

Gallbladder status among children with chronic hemolytic anemia attending Assiut University Children's Hospital

BackgroundOne among the numerous comorbidities of chronic hemolytic anemia (CHA) is bladder stones. The extensive use of abdominal ultrasound in kids documented raised detection rate of gallstones.Aim and objectivesTo see the frequency of gallbladder diseases among kids with CHA and to see the risk factors of gallbladder diseases among patients with CHA attending Assiut University Children's hospital.Patients and methodsThis cross-sectional study included 50 kids with CHA aged from 1 to 18 years, who were admitted to the Hematology Unit at Assiut University Children's Hospital (from the start of December 2018 to the end of November 2019). All patients were evaluated by full history, general and abdominal examination, laboratory assessment, and ultrasound findings to find the probable risk factors for gallstones.ResultsThe age of patients ranged from 1 year up to 18 years. The commonest age of bladder diseases detection was at 6 years. Twenty-one (42%) cases had gallbladder diseases. Bladder diseases were symptomatic in –81 with abdominal pain in affected kids. Thalassemia major was recorded more frequently (72%) in the studied group with 20 and 8% reporting sickle cell anemia and spherocytosis, respectively. The frequency of blood transfusion had statistical significance with gallbladder affection.ConclusionFrom this study, it can be concluded that the type of hemolytic disease, frequency of blood transfusion, history of hydroxy urea intake, and splenomegaly were risk factors for gallbladder affection in children with chronic hemolytic disease.

Effect of Intervention on Glycaemic Control among Adult Population with Type 2 Diabetes Mellitus and Comorbid Depression in Central Karnataka, India

Background People living with Type 2 diabetes mellitus with comorbid depression have increased chances of poorer outcomes in terms of glycaemic control or medication adherence and even quality of life.Objective The present study aimed to estimate the effect of intervention on glycemic control among adult population with Type 2 diabetes mellitus and comorbid depression who had received either treatment with an antidepressant medication ADM or a psychotherapeutic intervention like cognitive-behavioural therapy CBT. Methods The study was carried out at a tertiary care teaching hospital in Central Karnataka. The study participants were adult patients 30ndash70 years with type 2 diabetes mellitus of over 12-month duration with no prior history of psychiatric illnesses or intake of anti-depressants. Data was collected using a pre-tested semi-structured questionnaire.Results In the post-intervention phase the participants who received cognitive-behavioral therapy CBT had significantly lower depression scores on the Montgomery and Asberg Depression Rating Scale MADRS when compared to subjects who were on antidepressant medication ADM 95 CI -10.068 to -9.606 p lt0.0001. Similarly in terms of diabetes control the participants who received CBT had better glycemic control as measured by HbA1c levels compared to those who received ADM 95 CI -1.4632 to -0.5108 p lt0.0001.Conclusion In patients with diabetes with comorbid depression interventions to treat depression could improve diabetes care. Overall these results suggest that a behavioural intervention for depression is effective for managing depression and improving glycemic control in adults with type 2 diabetes.

Risk factors of Hemorrhagic Stroke- a Case-Control Study in Bangladesh

Background: Spontaneous intracerebral hemorrhage is one of the leading causes of mortality and morbidity. Genetic factors play an important role in this disease. Among the non-genetic causes Hypertension (HTN), IDDM (insulin dependent diabetes mellitus), NIDDM (non-insulin dependent diabetes mellitus), family history of hemorrhagic stroke, smoking, previous history of ischemic stroke, alcohol intake and education level are important. Methods: The aim of the study was to evaluate the association between ICH and non-genetic risk factors. This was a case-control study with 120 participants. The place of the study was in the Neurosurgery department of Sylhet Women’s Medical College Hospital (SWMCH) and the study period was 2 years. Result: Alcohol consumption (RR=3, Odd=3.11) showed highest risk for ICH. Other risk factors of ICH were smoking (RR=2, Odd=2.36), family history (F/H) of ICH (RR=1.3, Odd=1.38), Hypertension (RR=1.1, Odd=1.39) and below 12 class education status (RR=1.08, Odd=1.63). The relative risk of IDDM, NIDDM, previous history (P/H) of ischemic stroke were less than 1. Conclusion: There are few controllable risk factors of hemorrhagic stroke apart from genetic risk factors.

Squamous Cell Carcinoma Arising in Lesions of Discoid Lupus Erythematosus in a Patient with Overlap Syndrome: A Chronic Rare Complication.

Squamous Cell Carcinoma Arising in Lesions of Discoid Lupus Erythematosus in a Patient with Overlap Syndrome: A Chronic Rare Complication.

The anti-aging mechanism of ginsenosides with medicine and food homology.

With the acceleration of global aging and the rise in living standards, the achievement of healthy aging is becoming an imperative issue globally. Ginseng, a medicinal plant that has a long history of dietary intake and remarkable medicinal value, has become a research hotspot in the field of food and medicine. Ginsenosides, especially protopanaxadiol-type saponins and protopanaxatriol-type saponins, are among the most important active ingredients in ginseng. Ginsenosides have been found to exhibit powerful and diverse pharmacological activities, such as antiaging, antitumor, antifatigue and immunity enhancement activities. Their effects in antiaging mainly include (1) promotion of metabolism and stem cell proliferation, (2) protection of skin and nerves, (3) modulation of intestinal flora, (4) maintenance of mitochondrial function, and (5) enhancement of telomerase activity. The underlying mechanisms are primarily associated with the intervention of the signaling pathways in apoptosis, inflammation and oxidative stress. In this review, the mechanism of action of ginsenosides in antiaging as well as the potential values of developing ginsenoside-based functional foods and antiaging drugs are discussed.

Association of drugs, reproductive and lifestyle factors with carcinoma breast among women in a tertiary care center - a case–control study

Background: Breast Cancer is the most common cancer in the world and a leading cause of cancer deaths. The incidence and mortality vary widely. Multiple factors are found to be associated with the development of breast cancer. Aims and Objectives: To study the role of drugs and other selected factors in the development of carcinoma breast. Materials and Methods: A case–control study was done at Government Medical College Thrissur. Selected 125 cases and 250 controls. Data were collected by interview using a semi-structured proforma. The role of drugs, Body Mass Index (BMI), lifestyle, and reproductive factors were studied. Results: The cases and controls were matching in their sociodemographic characteristics. The mean age of cases was 53 years (SD = 11.5) and that of controls was 51.74 years (SD = 11.5). Hysterectomy was found to be a risk factor of breast cancer, Odds Ratio 2.3 (1.05–5.05). Heavy work, with an Odds Ratio 0.89 (0.12–0.66), and milk consumption with an odds ratio 0.46 (0.27–0.78) were found to be protective factors. contraceptive pill, hormone replacement therapy, prolonged drug intake, BMI, age of menarche, parity, abortion, or infertility were not found to have significant association. Conclusion: The history of drug intake is not having a role in the development of breast cancer. Hysterectomy is a risk factor while heavy work and milk consumption are protective factors in breast cancer development.

The Association between DASH Diet Adherence and Cardiovascular Risk Factors.

The dietary approaches to stop hypertension (DASH) encourages high fruit, vegetable, and lean protein consumption and low salt, red meat, and fat intake to prevent or treat hypertension. However, besides hypertension, adherence to this diet has been shown to decrease other cardiovascular risk factors. This study assessed the relationship between the DASH diet and cardiovascular risk factors in a cross-sectional study of 2,831 adults chosen by multistage cluster sampling from 27 counties of Khuzestan province, Iran. DASH scores were calculated using data obtained from a qualitative food frequency questionnaire. Regression models were used to evaluate the association of DASH scores and common cardiovascular risk factors. Significant trends were observed across quintiles of DASH scores for systolic blood pressure, fasting blood sugar, triglyceride, total cholesterol, and its components (p < 0·05). After adjusting for potential confounders such as sex, age, ethnicity, residence, wealth score, physical activity, energy intake, and family history of heart disease, the multiple regression analysis for each cardiovascular risk factor revealed that being in the highest quintile of total DASH score (OR = 0.72, 95% CI 0.52-0.99) was negatively associated with hyperglycemia. This study showed a positive relationship between DASH diet adherence and lower serum levels of glucose, triglycerides, and cholesterol. Prospective studies are needed to confirm these findings.

A Review on Forensic Toxicological Analysis of Drugs in Hair using Various Instrumental Techniques

Forensic analysis of drugs in hair using various modern instrumental analysis involves the use of different analytical techniques to detect, identify drugs and their metabolites that may be present in the hair. Forensic analysis of drugs from hair using instrumental analysis is a valuable tool for law enforcement agencies, workplaces, and drug treatment programs also in suspicious death due to poisoning, drug overdose, and doping in sports. Hair provides various advantages over urine and blood, such as easy sample collection and has the ability for providing retrospective drug intake or past history of drug abuse. Drug analysis in hair requires a smaller sample size, advancements in sample preparation techniques with lowered detection limits in instrumental analysis. Additionally, hair provides a chronological overview of the drug of abuse with reference to its micro-segmental analysis. This review paper aims to provide thorough understanding of the various instrumental techniques that are used to extract, isolate, identify the drugs and their metabolites based on their chemical and physical characteristics and their quantification in the hair. In majority of the cases, hair is not appreciated for its attributes as evidence. This paper tries to focus on the evidentiary value of hair and the techniques that are available globally

The Epidemiological and Clinical Characteristics of the Largest Outbreak of Enterohemorrhagic Escherichia coli in Korea.

The largest outbreak of enterohemorrhagic Escherichia coli (EHEC) O157:H7 occurred at a preschool in South Korea from June 12 to 29, 2020. This study aimed to analyze the epidemiological and clinical characteristics of EHEC infection in this outbreak. Epidemiological investigation was performed on all 184 children and 19 workers at the preschool using a standard questionnaire to assess symptoms, food intake, attendance, and special activity history. Pulsed-field gel electrophoresis analysis of confirmed cases was performed to determine genetic relevance. During this outbreak, 103 children were affected, whereas only one infection was identified in adults. Of the 103 pediatric patients, 85 had symptoms (82.5%), including diarrhea, abdominal pain, bloody stool, fever, and vomiting. Thirty-two patients (31.1%) were hospitalized, 15 (14.6%) were diagnosed with hemolytic uremic syndrome, and 4 (3.9%) received dialysis treatment. Pulsed-field gel electrophoresis analysis identified 4 genotypes with high genetic relevance (92.3%). Epidemiological investigation revealed that this outbreak might have occurred from ingesting foods stored in a refrigerator with a constant temperature above 10°C, which was conducive to bacterial growth. Despite several measures after outbreak recognition, new infections continued to appear. Therefore, the preschool was forced to close on June 19 to prevent further person-to-person transmission. Our findings from the response to the largest outbreak will help prepare countermeasures against future EHEC outbreak.

Amitraz poisoning – A rare and uncommon case of poisoning and its management

A 25-year-old male presented to the peripheral hospital with an alleged history of ingestion of amitraz toxin 12.5% (approximately 150 mL), and presented with complaints of nausea, vomiting, abdominal pain, and weakness. On examination, he was conscious but disoriented and agitated, oxygen saturation (SpO2) was 89%–90% on room air, pulse rate was 40/min, blood pressure (BP) was 110/70 mmHg, and bilateral (B/L) crepitations were present on auscultation. Emergency treatment included – intravenous(IV) fluid, atropine 0.6 mg IV, and gastric lavage. Oxygen was given through an oxygen mask with a reservoir bag at 10 L/min. After some time, the patient's Glasgow Coma Scale (GCS) started deteriorating, and arterial blood gas (ABG) analysis revealed severe acidosis with pH of 7.109, pCO2 – 73, and HCO3 – 23.1, and immediately, the patient was transferred to a higher center given falling GCS, decreased saturation, and ABG finding. On presentation in the emergency department in our tertiary care center, the patient was unconscious, SpO2 was 69% on oxygen nonrebreathing mask – NRBM Mask at 15 L, BP was 128/78 mmHg, pulse rate was 104/min, and B/L crepitations were present on auscultation. The patient was immediately intubated in casualty and shifted to the intensive care unit for further management. Amitraz is a triazapentadiene, 1,5 di (2,4 dimethylphenyl) 3 methyl 1,3,5 triaza penta 1,4 diene, a formamidine pesticide, α2 adrenergic agonist in the central nervous system belongs to the amidine chemical family. The systemic effect of amitraz toxin is due to the activation of the pure α2-adrenergic agonist. It is a rare kind of poisoning in humans, and there exists a paucity of literature on the management of the aforementioned poisoning. Only a limited number of case reports of human intoxication have been published and most of them are of accidental ingestion by children. Due to insubstantial data on its management, this case report will be advantageous for practitioners working in emergency and intensive care departments.

Outcome prediction using sequential organ failure assessment (SOFA) score and serum lactate levels in organophosphate poisoning.

Organophosphorus compounds are widely used as pesticides in agriculture practicing countries like India. Since it is readily available and accessible, it is one of the most commonly used agents for suicidal poisoning. The current study was undertaken to evaluate the performance of the SOFA score (scoring system) and the serum lactate level (laboratory parameter) as a mortality predictor in organophosphorus poisoning. This prospective observational study was conducted at AIIMS, Bhubaneswar, for 17 months. The study population included all patients with an alleged history of ingestion of organophosphorus (OP) compounds reporting to the casualty. The receiver operating characteristic (ROC) curve and the logistic regression analysis were used for the analysis. In our study, 75 patients with OP poisoning were studied after satisfying the inclusion criteria. OP poisoning was commonly seen in married males aged 21-40 years. Twelve (16%) patients died during the process of treatment. There was a statistically significant difference in the mean SOFA score, serum lactate level, pH value, and mean duration of hospital stay between the discharged and the deceased patients. In the current study, the ROC curve analysis used to assess the predictor of the outcome of OP poisoning showed that the area under the curve for SOFA score and serum lactate level were 0.794 (95% CI 0.641-0.948) and 0.659 (95% CI 0.472-0.847), respectively. Sequential Organ Failure Assessment (SOFA) score is significantly associated with the outcome of organophosphate poisoning and can be utilized to predict mortality.

Clinical and Dermoscopic Evaluation of Melasma in Men- An Observational Study at a Tertiary Health Care Centre in Western Odisha, India

Introduction: Melasma is one of the most common cause of facial hypermelanosis presenting as symmetrical hyperpigmented macules over sun exposed areas especially in women and sizeable proportion in men causing a detrimental effect on the quality of life. Aim: To evaluate the clinical profile and dermoscopic features of melasma in men. Materials and Methods: A cross-sectional, observational study was conducted at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla, Odisha, India, from November 2018 to October 2020. 245 men, clinically diagnosed with melasma were included in the study with due consent and evaluated for age, family history, skin type, drug intake history, duration, duration of sun exposure, disease pattern, Melasma Area Severity Index (MASI) Score and dermoscopic feature. Data was collected using questionnaire, managed by Microsoft excel 2016 and analysed using Statistical Package for Social Sciences (SPSS) 20.0. Results: Melasma occurred most commonly in the age group of 31-35 years (37.9%) with mean age of occurrence being 34.5±7.9 years affecting most commonly Fitzpatrick skin type IV (47.3%). There was positive family history in 63 patients (29.7%) and history of Diabetes Mellitus (DM) type 2 in 24 cases (9.7%). There was increased occupational sun exposure in 93% of cases with average duration of exposure being 7-8 hours/day in 98 cases (42.9%). The most common clinical pattern observed was malar pattern in 156 cases (63.6%) and epidermal dermoscopic pattern in 128 cases (52.2%). Majority of cases had a MASI Score between 5-10 with mean being 8.7±7.7. On comparing MASI Score and sun exposure, the average sun exposure was highest for a MASI Score 20-25 i.e., 7.4 hours/day. Conclusion: The most common age group affected by melasma in males is 20-40 years, with prevalence being greater in higher Fitzpatrick skin type (III, IV), with positive history of occupational sun exposure and positive family history. The severity of melasma in form of MASI score was formulated. The knowledge acquired through the study can help bridge the knowledge gap to improve its management and quality of life.

Subjective Global Assessment of Nutritional Status among Chronic Kidney Disease Dialysis Patients: A Cross-sectional Study

Introduction: Nutritional status is compromised in End-Stage Renal Disease (ESRD) patients on dialysis. In order to predict the clinical outcomes of these patients, the diagnosis of nutritional status becomes extremely important. However, data related to parameters assessing nutritional status are limited. Aim: The aim of this study was to assess the nutritional status of dialysis patients with ESRD at the renal care unit of a tertiary care hospital. Materials and Methods:A cross-sectional study was conducted at the renal care unit of a tertiary care hospital from January 2016 to July 2016. Fifty individuals were divided into two groups: 30 stable ESRD patients on Haemodialysis (HD) and 20 stable ESRD patients on Continuous Ambulatory Peritoneal Dialysis (CAPD). Data were collected using a questionnaire regarding nutritional assessment, which comprised medical history, food intake history, anthropometry, biochemical investigations, and Subjective Global Assessment (SGA). Based on the SGA analysis of nutritional status, the patients were divided into Categories A, B, and C. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 22.0. Results: A total of 50 subjects were included in the final analysis - 30 patients in the renal dialysis group and 20 patients in the CAPD group. Body Mass Index (BMI) was significantly higher in the HD group (21.78±2.86 kg/m2 ) than in the CAPD group (20.87±2.63 kg/m2 ). In the HD group, the majority were in Category B (60%). In the CAPD group, the majority were in Category B (70%). The mean anthropometric measurements were significantly higher in Category A, followed by B and C (p&lt;0.001). There was no significant difference across groups in biochemical parameters, except for serum albumin levels, which were significant. Serum albumin levels were highest in Category A, followed by Category B, and Category C in reverse for S. Prealbumin (mg/dl). Conclusion: There is a significant number of ESRD patients who have malnutrition as an additional burden. These results suggest that low BMI and low calorie intake are harmful to ESRD patients on HD, causing severe malnutrition. Optimal calorie intake could reduce malnutrition in these patients.

Study of Risk Factors for Acute Myocardial Infarction in Western Maharashtra: A Case-Control Study

Introduction: Myocardial infarction (MI) is one of the leading causes of mortality in India. The associated risk factors vary with respect to geographical and cultural difference in patients of MI. Objective: To study the association between known risk factors and MI in patients visiting tertiary rural health care center. Method: The study design was Unmatched Case Control type. Patients of age 18 or above diagnosed of AMI were included as cases. Patients of age 18 or above without prior history of heart disease were included as controls. Pregnant women and patients with coexisting cardiogenic shock, any significant chronic medical illness was excluded. The history of hypertension, Diabetes, family history of CHD, stress in past 1 year, history of alcohol intake, History of tobacco addiction, type of activity at work were recorded. The comparison of case and controls were done using Chi squared test, Fisher's Exact Test and Odds ratio, wherever applicable. A one sided “p” value of &lt;0.05 was considered significant. Results: Of the 230 study participants included in the study, 100(43.5 %) were cases and 130 (56.5%) were Control, respectively. Except for history of stress, there was no statistical difference between number of cases and controls. Conclusion: The known risk factors of MI were not found associated with the disease. There is a need for conduct of study with larger sample size for confirmation of the study results.

Pattern of Agricultural Poisoning in District Level Hospital

Background: In Bangladesh, acute poisoning is a serious public health issue. Suicide by this manner is rather prevalent. Every area needs a detailed picture of clinical presentation, the most widely utilized hazardous substances, background circumstances, and the result of poisoned patients. The study's goal is to look at the occurrence and outcomes of acute poisoning episodes in Pabna Upazila, Bangladesh. Objective: To find out the chemical types of agricultural poison and out of the acute poisoning cases by agricultural poisons. Materials and Methods: This is a prospective study, carried out in Pabna Sadar Hospital between April 2019 to December 2019. Results: A total of 120 patients were studied in this study. There were 23 males and 97 females. The average age group for acute poisoning was 15-25 years. The major toxic agent that caused the acute poisoning death was OPC. The average hospital stay was 2-3 days, and 82% of patients were fully recovered and discharged. Conclusion: Acute poisoning cases were more in young age group, female; most of the patient had history of ingestion of OPC and more than two-third cases recovered. KYAMC Journal Vol. 13, No. 03, October 2022: 145-148

Epidemiology, potential risk factors and outcome of black fungus during COVID-19 pandemic: a concurrent prospective study at a dedicated COVID-19 hospital of North India

Introduction: As the number of COVID-19 patients increased during second wave, a steep rise of patients with mucormycosis was found in all parts of India. Objectives: To determine the epidemiological factors leading to the rise in fungal infection in patients during COVID-19 pandemic as well as describe the outcome of the disease during next three months after being discharged from the hospital Methods: It was a concurrent prospective study conducted between 26 June to 25 October 2021 at ESIC Medical College &amp; Hospital, Faridabad, India. Patients positive for mucormycosis and agreed for the study were enrolled. They were interviewed telephonically after recording their consent. Results: A total of 51 patients were interviewed during our study period. During the follow-up, six patients died within three months of discharge from the hospital. The mean age of patients was 49.6years (SD=6.9 years), with the majority in the age group of 41-60 years. Most (53%) of the patients were males and 30(58.8%) were graduates and above. In the sample, 33 had a recent history of COVID-19 infection, 24 (47%) had been prescribed steroids, 16 (31.3%) had been prescribed oxygen during COVID-19 infection and 33(64.7%) were diabetic. The relationship of potential risk factors with the type of mucormycosis was not found to be statistically significant. Out of the45 patients who survived, 35 were better, three were still on oral anti-fungal treatment and seven patients required reconstructive plastic surgery. A significant association was found between patients who had a history of steroid intake and type of mucormycosis. Conclusions &amp; Recommendations: Patients admitted to hospital with mucormycosis during the COVID-19 surge mostly had a history of COVID-19 infection, suffering from diabetes or on steroids. Most of the patients survived due to treatment availability (antifungal medicines, surgery or both) and about 15% of them had undergone long debridement surgery leading to severe loss of normal contour of the face and waiting for plastic reconstructive surgery.

Perioperative Nutritional Status of Digestive Surgery Laparotomy Surgery

Introduction: Laparotomy is one of the most frequently performed surgical procedures. Surgery causes a stress response that increases the risk of experiencing malnutrition, especially in patients undergoing laparotomy. Malnutrition can increase the risk of adverse outcomes in postoperative patients. This study aims to evaluate perioperative nutritional status in patients who will undergo laparotomy surgery at Haji Adam Malik General Hospital Method:This research is an observational study with a prospective design. This study involved 65 research subjects withthe sampling technique was carried out by non-probability sampling, namely consecutive sampling. Results:The majority of study subjects had BMI ≥18.5, without weight loss &gt;3.6 kg in the last 6 months, without a history of food intake &lt;50% portion in the last 1 week, and albumin value ≥3.0 pre- and post- operative. Postoperatively. The number of subjects with PONS value ≥1 changed from 33.85% before surgery to 52.31% after surgery. There was a significant change in PONS values ​​before and after laparotomy (p = 0.001). Conclusion:Statuspost-operative nutritional study subjects decreased compared to before surgery. A significant increase in PONS scores also occurred after laparotomy.