Increased incidence of rhino-orbital mucormycosis in an educational therapeutic hospital during the COVID-19 pandemic in western Iran: An observational study.

BACKGROUND: COVID-19 patients, especially the patients requiring hospitalisation, have a high risk of several complications such as opportunistic bacterial and fungal infections. Mucormycosis is a rare and opportunistic fungal infection that mainly affects diabetic and immunocompromised patients. An increase has been observed in the number of rhino-orbital mucormycosis in patients with COVID-19 admitted to Imam Khomeini Hospital, Kermanshah, Iran, since October 2020. This is a report of the frequency, risk factors, clinical manifestations, treatment and prognosis of COVID-19 associated with mucormycosis infection. METHODS: The medical records of COVID-19 patients with rhino-orbital mucormycosis who were diagnosed in an educational therapeutic hospital in Kermanshah, west of Iran were surveyed. Several parameters were analysed including demographic, clinical, therapeutic and laboratory characteristics. RESULTS: Twelve patients with COVID-19-associated rhino-orbital mucormycosis were identified from 12 October to 18 November 2020. All cases reported as proven mucormycosis had a history of hospitalisation due to COVID-19. Comorbidities mainly included diabetes mellitus (83.33%) and hypertension (58.33%). Seventy-five per cent of patients received corticosteroids for COVID- 19 treatment. The sites of involvement were rhino-sino-orbital (83%) and rhino-sino (17%). Amphotericin B/liposomal amphotericin B alone or in combination with surgical debridement or orbital exenteration was used as the first-line therapy. The overall mortality rate was 66.7% (8/12). CONCLUSIONS: We found a high incidence of mucormycosis among COVID-19 patients. Diabetes mellitus and corticosteroid use were the dominant predisposing factor of mucormycosis. Mucormycosis is a life-threatening and opportunistic infection; therefore, physicians should know the signs and symptoms of the disease so that a timely diagnosis and therapy can be performed.

The outcomes of carpal tunnel decompression based on electro-diagnostic approaches and clinical symptoms in patients suffering from carpal tunnel syndrome (CTS).

Introduction: The main objective of this study was to assess the outcomes of carpal tunnel release surgery based on the electro-diagnostic approaches and its clinical symptoms in patients who suffered from carpal tunnel syndrome (CTS). Methods: This was a prospective cross-sectional study that consisted 50 participants of 100 patients of which 22 of them were men, and 78 of them were female. All the participants were examined through their clinical symptoms including pain, by parentheses, and also using the Levine-Katz Questionnaire before and after the open surgical operation. Additionally, patients with electrophysiological (EP) disorders were evaluated using electromyography (EMG) and nerve conduction velocity (NCV) (EMG-NCV) tests. Then, the association of the findings and results of this study was analyzed and then compared together using a particular statistical analysis model before and after the surgical procedure. Findings: The data achieved from the present study demonstrated that a significant improvement in both sexes and age groups was observed, and there was no significant difference in the level of improvement based on age and gender. Moreover, there was a significant correlation between the improvement severity of clinical symptoms and the improvement of severity of muscle nerve disease and their functions. Conclusion: It was observed that the surgical procedure for the treatment of carpal tunnel syndrome, improves its clinical symptoms in patients tested with electrodiagnostic techniques. Moreover, diversity of age and sexual condition did not affect the results of the study.