Clinical-epidemiological Profile of Coronavirus Disease 19 Associated Mucomycosis (CAM) and Relation with Zinc and Iron Levels.

INTRODUCTION: Coronavirus disease associated mucormycosis (CAM), perturbed a lot by reaching to epidemic proportions particularly during the second wave of the pandemic. MATERIAL AND METHODS: This was a retrospective, observational study of patients with COVID-19-associated mucomycosis admitted in April-May 2021 at a tertiary care teaching hospital. Demographic profile, clinical and laboratory parameters were recorded Multidisciplinary treatment including antifungals and surgical interventions were noted. RESULTS: This study included 98patients of mucormycosis, diagnosed on the basis of clinical and radiological findings and later were confirmed by microbiological investigations. Out of 98 patients, 72 had rhino orbital, 24 had rhino-orbitalcerebral and 2 had pulmonary mucormycosis. Twelve had coinfection of covid 19 while 86 had developed mucormycosis within 3 weeks. CONCLUSION: CAM has posed as a continuum of challenges faced during the pandemic of covid 19. This rare and life threatening complication requires high index of suspicion for early diagnosis. Multidisciplinary involvement and timely interventions including antifungal pharmacotherapy, stringent glycemic control and surgical debridement can reduce the mortality. Mucormycosis is uniformly associated with low iron levels but role of zinc needs to be further studied.

Neutrophil Gelatinase-associated Lipocalin (NGAL) as a Marker of Renal Tubular Injury in Metabolic Syndrome Patients with Hyperuricemia.

BACKGROUND: Hyperuricemia has been associated with chronic kidney disease, evidence suggests that hyperuricemiamight plays a role in progression of renal damage. Whether hyperuricemia can lead to renal tubular injury remains unclear. In this study we aimed to determine serum NGAL and urinary NGAL/creatinine ratio as markers of reanal tubular injury in metabolic syndrome patientshave hyper or normouricemia. MATERIAL AND METHODS: In this hospital based cross- sectional study,180 par ticipants with metabolic syndrome were included,90 patients had hyperuricemia and 90 were with normouricemia. Clinical biochemical parameters of serum NGAL and urinary NGAL were measured using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. Receiver operating characteristic(ROC) curve was analysis was employed to assess the sensitivity and specificity of serum NGAL and urine NGAL/creatinine ratio. RESULTS: Out of all, 96 were males and 84 were females. The mean age of participants was 45 ± 7 years. Serum NGAL levels and Urinary NGAL/creatinine ratio were higher in metabolic syndrome patients with hyperuricemia. High Serum NGAL was positively correlated with presence of hypertension; HbA1c and waist-hip ratio and negatively correlated with HDL. CONCLUSION: Serum NGAL levels and urinary NGAL/creatinine ratio were higher in metabolic syndrome patients with hyperuricemia that indicates presence of renal tubular injury in these patients. High Serum NGAL was positively correlated with presence of hypertension; HbA1c and waist-hip ratio.