Clinical and histology features as predictor of severity of mucormycosis in post-COVID-19 patients: An experience from a rural tertiary setting in Central India.

BACKGROUND: An upsurge in cases of rhinosinusitis with or without associated orbital and/or cerebral involvement by mucormycosis has been observed in post-COVID-19 patients. Our objective is to evaluate the clinical and histopathology features of these patients to determine the severity and develop a scoring on the extent on tissue invasion. METHOD: We prospectively enrolled and analyzed 95 post-COVID-19 patients who presented with the invasive mucormycosis of the head and neck region. Clinical and histology details were noted in predesigned forms. Various histology variables were graded from I to III to propose a scoring system for the severity of the disease. RESULTS: Mucormycosis was common in males with a mean age of 46.8 ± 11 years. Facial pain was the most common presenting complaint and 77% of the patients were diabetic. Most cases (n = 59) showed a moderate degree of neutrophilic infiltrate with ⩾50% tissue necrosis and angioinvasion in three or more vessels with a fungal load of 2+/3+. Histology severity grade III was observed in patients who died from cerebral mucormycosis (n = 3) and septicemia (n = 2) and in patients who had undergone orbital exenteration (n = 6). CONCLUSION: The histopathology and severity score classification was directly correlated with the outcome of the patients. Further evaluation and a larger study will help to validate the proposed scoring for its clinical use in all forms and causes of mucormycosis.

Helicobacter pylori Associated Gastritis in Northern Maharashtra, India: A Histopathological Study of Gastric Mucosal Biopsies.

INTRODUCTION: Helicobacter pylori (H.pylori) are of major concern today because of its causal relationships with gastrointestinal diseases. It represents one of the most common and medically important infections worldwide. H.pylori plays a key role in the aetiology of chronic gastritis, duodenal ulcer, gastric carcinoma and MALT lymphoma. There is paucity of literature regarding the morphological changes in H.pylori associated gastritis. AIM: We undertake this study to find out the association and prevalence of H.pylori associated gastritis by histopathological methods in North Maharashtra, India. MATERIALS AND METHODS: A total 310 patients with various upper gastrointestinal disorders were included in this study over the period of 19 months from July 2013 to January 2015. The detailed clinical history was taken and patients were subjected to video gastroscopy. Each biopsy was studied with Haematoxylin and Eosin/Giemsa method. RESULTS: The prevalence of H.pylori was high in third to fourth decades. Out of 310 patients of gastrocopy, 144 were H.pylori positive by Haematoxylin and Eosin/Giemsa method. Morphological changes specific for H.pylori was noted as atrophy and irregular gastric mucosa, lymphoid aggregates and reactive atypia. Male patient were outnumbered by female patients. CONCLUSION: Histopathological evaluation is the gold standard for diagnosing H.pylori infection. Prevalence of H.pylori in the present study was 46.5% in patients undergoing videogastroscopic biopsies for gastritis and vague upper gastrointestinal symptoms. Furthermore and large scale studies are required to establish the diagnostic modalities for H.pylori associated gastritis to prevent morbidity and mortality.

Gastrointestinal stromal tumour of small intestine presenting as a mesenteric mass.

Gastrointestinal stromal tumors (GISTs) are uncommon tumors; accounts for 0.1% to 3% of all gastrointestinal neoplasm. Most common site of involvement is stomach (60-70 %), small intestine (20-30 %) and rarely at extra-gastrointestinal sites like omentum and mesentery called as extra-gastrointestinal stromal tumor (EGIST). Diagnosis is based on characteristic histological findings and expression of transmembrane receptor tyrosine kinase protein (CD 117) derived from activated c-kit gene. Herein, we report a case of GIST of small intestine presented as mesenteric mass in a 35- year-old female and discuss review of literature.