Mucormycosis and Its Co-Relation with Raised Ferritin Levels

Background: Mucormycosis has emerged as an epidemic within the COVID-19 pandemic due to widespread use of corticosteroids and immune-modulators like Tocilizumab, in the management of COVID-19 pneumonia. It is an invasive fungal disease which spreads by angioinvasion and rapidly spreads to adjacent tissues. If untreated its outcomes are dangerous and often fatal. Uncontrolled diabetes, malignancies and dialysis are predisposing factors. Raised blood iron is an important factor in pathogenesis and rapid progression of fungal invasion that needs to be investigated. Aim: To establish a correlation between raised serum ferritin level and aggressiveness of Mucormycosis. Methodology: Aretrospective study was done from February 2021 to February 2022 of patients diagnosed with mucormycosis by middle meatal biopsy and microscopy along with CT& MRI scan of PNS with brain. They were treated either surgically or conservatively. All the blood parameters including serum ferritin level, were carried out. Acomparison was done on extent of disease in patients in-relation to their serum ferritin level. Results: Our study suggested that higher levels of ferritin are often associated with aggressive form the disease. Zygomycetes are dependent on environmental iron for their growth. Higher the serum ferritin level, more aggressive & widespread is mucormycosis. Conclusion: Serum free iron aggravates mucormycosis. Measures should take to control the serum ferritin in patients under risk for mucormycosis. Iron chelating agents or novel methods like anti-ftr1 immune serum should be developed for controlling the disease at its earlier stages

Significance of Inner Nasal Valve In Septoplasty

Background: Nasal obstruction due to deviated septum is commonly treated with conventional septoplasty. This surgery however is inadequate in cases of compromised nasal valves and leads to persistent symptoms. Hence, we stressed the evaluation of nasal valves before septal surgery & studied the outcome of the patients with valve area correction. Aim:To prove the signi?cance of inner nasal valve in nasal surgery. Objective: To analyse the outcome of Open septoplasty. Methodology:A retrospective review of our patients undergoing Open septoplasty was analyzed from April 2016 to January 2021. The preoperative and post-operative evaluations were calculated & statistically analysed. Results :A total of 400 patients underwent Open septoplasty, out of which 392(98%)showed symptomatic improvement in breathing dif?culty. Also, 220 patients out of total 400 underwent cosmetic correction along with open septoplasty & 209 (95%) out of these220 were completely happy with the asthetic improvement. Conclusion:Open septoplasty and Spreader grafts is best solution to improve Internal Nasal valve angle. Rim graft to improve external valve collapse. Spreader graft also gives asthetic along with functional improvement.