Correlation of microvessel density with histopathological parameters of carcinoma breast.

BACKGROUND OBJECTIVES: Microvessel density (MVD) is a surrogate measure of tumour angiogenesis, and is well known for over two decades to identify individuals with a high risk of recurrence with greater prevision than traditional markers. This study aims to assess the utility of MVD and its correlation with the Nottingham Prognostic Index (NPI) and other routine histopathological parameters in carcinoma breast. METHODS: This two year retrospective, cross-sectional and analytical study evaluated 143 women with breast cancer presenting to rural tertiary hospital in central India. These women were graded histopathologically, the immunophenotype was determined using ER (estrogen receptor), PR (progesterone receptor), Her2 neu (human epidermal growth factor receptor 2 neu) and Ki-67 proliferation index (Kiel-67) immunohistochemical markers and anti-CD34 antibody to stain the endothelial cell clusters displaying the microvessels. The NPI was generated for each participant based on the tumour size, histologic grade and involvement of lymph node. The parameters were compared with the CD34 scores. Differential and inferential statistics, including the independent t test, analysis of variance, Pearson's correlation coefficient, Spearman's rank correlation coefficient and point biserial correlation coefficient, were used for statistical analysis. RESULTS: This study showed that CD34 values ranged from 6-36 microvessels/hpf, with 24.16±6.77 microvessels/hpf as the mean. The mean microvessel counts showed a significant positive correlation with the Bloom-Richardson histological grade, vascular invasion, LN (lymph node) positivity and NPI. However, there was no significant correlation of CD34 values with the participant's age, tumour size neither any significant association of CD34 values with the individual's immunophenotype. INTERPRETATIONS CONCLUSIONS: A positive linear correlation of the microvessel counts and the NPI scores suggest that with an increase in tumour angiogenesis, there was increased proliferative potential. Based on the significant correlation between the microvessel counts and the vascular invasion of the tumour masses in this study, it can be assumed that there will be vascular invasion if the microvessel count is higher and vice-versa. Although it is established that angiogenesis and neovascularization are required for the expansion of the solid tumour tissue, the heterogeneous nature of this entity makes it difficult for obtaining a linear correlation. Hence, it is suggested that though neovascularization permits advanced tumour spread it, however, does not guarantee it.

Comparison of PIRO, APACHE IV, and SOFA Scores in Predicting Outcome in Patients with Sepsis Admitted to Intensive Care Unit: A Two-year Cross-sectional Study at Rural Teaching Hospital.

Introduction: Though many scoring systems for prognostication of sepsis are available in the intensive care set-up, predisposition, insult, response, and organ dysfunction (PIRO) score helps to assess each patient and evaluate response to therapy. There are few studies comparing the efficacy of PIRO score with other sepsis scores. Hence, our study was planned to compare PIRO score with acute physiology and chronic health evaluation IV (APACHE IV) score and sequential (sepsis-related) organ failure assessment (SOFA) score in predicting the mortality of intensive care patients with sepsis. Materials and methods: This prospective cross-sectional study was done in the medical intensive care unit (MICU) from August 2019 to September 2021 among patients above 18 years of age with the diagnosis of sepsis. Predisposition, insult, response, and organ dysfunction score, SOFA score, and APACHE IV score on admission and at day 3 were calculated and statistically analyzed in the terms of outcome. Results: A total of 280 patients fulfilling the inclusion criteria were included in the study, the mean age was 59.38 ± 15.9 years. There was a significant association of PIRO score, SOFA score, and APACHE IV score on admission and at day 3 with mortality (p-value <0.05). Among all three parameters, the PIRO score on admission and at day 3 was the best predictor of mortality at cut-off points of >14 and >16 with 92.50% and 96.50% chances of correctly predicting mortality, respectively. Conclusion: Predisposition, insult, response, and organ dysfunction score can be considered as a strong predictor of prognostication of patients with sepsis admitted to the intensive care unit (ICU) and predict mortality. It should be routinely used as it is a simple and comprehensive score. How to cite this article: Dronamraju S, Agrawal S, Kumar S, Acharya S, Gaidhane S, Wanjari A, et al. Comparison of PIRO, APACHE IV, and SOFA Scores in Predicting Outcome in Patients with Sepsis Admitted to Intensive Care Unit: A Two-year Cross-sectional Study at Rural Teaching Hospital. Indian J Crit Care Med 2022;26(10):1099-1105.

Interleukin 6 and Its Correlation with COVID-19 in Terms of Outcomes in an Intensive Care Unit of a Rural Hospital:A Cross-sectional Study.

BACKGROUND: Interleukin 6 (IL-6) encoded by the gene coded as IL 6 acts as a proinflammatory cytokine as well as an anti-inflammatory myokine. It is postulated that IL 6 is associated directly with the severity of coronavirus disease-2019 (COVID-19). Another domain that is thought to predict the severity of COVID-19 is the neutrophil:lymphocyte (N:L) ratio; a higher N:L ratio is postulated to be related to more severe outcomes. Thus, the present study was aimed to establish a correlation of COVID-19 with IL-6 in terms of clinical outcomes. We had also tried to find the relationship between IL-6 and N:L ratio and high-resolution computed tomography (HRCT) score. METHODS: We have conducted a cross-sectional study of 200 patients who were admitted to the intensive care unit (ICU) with reverse transcriptase-polymerase chain reaction (RT-PCR) positive for COVID-19 from January to May 2021. Serum IL-6, N:L ratio, and HRCT chest were conducted on admission. RESULT: Out of 200 patients who were admitted to the ICU with COVID-19, while the IL-6 was higher in patients with increased N:L ratio and HRCT score, the association of IL-6 with clinical outcomes in terms of discharged and expired was found to be statistically not significant. CONCLUSION: Serum IL-6 was found not to be a potent marker for clinical outcomes in ICU patients in terms of death vs survived. However, the IL-6 levels on admission can be correlated with the computed tomography (CT) severity scores as well as N:L ratio of patients admitted to an ICU. HOW TO CITE THIS ARTICLE: Talwar D, Kumar S, Acharya S, Raisinghani N, Madaan S, Hulkoti V, et al. Interleukin 6 and Its Correlation with COVID-19 in Terms of Outcomes in an Intensive Care Unit of a Rural Hospital: A Cross-sectional Study. Indian J Crit Care Med 2022;26(1):39-42.

Inflammatory Myofibroblastic Tumor of the Lung: A Report of a Rare Case.

The uncommon and mysterious pulmonary inflammatory myofibroblastic tumor (PIMT) primarily affects children and young people. PIMT is characterized by the proliferation of myofibroblastic spindle cells mixed with inflammatory cells. It can resemble both benign and malignant disorders, both radiographically and clinically. PIMT typically manifests as a solitary lung tumor. The genesis of the tumor is linked to genetic anomalies, including those related to the ALK gene (anaplastic lymphoma kinase); nonetheless, some cases are not ALK-positive, indicating genetic variability. Clinically, patients may have non-specific symptoms such as cough, chest pain, or hemoptysis, or they may not exhibit any symptoms at all. In these cases, imaging tests may unintentionally reveal unrelated conditions. From a histopathological perspective, PIMT is characterized by a heterogeneous cellular makeup, encompassing lymphocytes, myofibroblasts, plasma cells, and histiocytes, which generally exhibit a fascicular or storiform pattern. The diagnosis is verified using immunohistochemical labeling, molecular research, and histological examination. The cornerstone of treatment is still surgical resection, which has a good prognosis and a low recurrence rate. On the other hand, specific treatments, such as ALK inhibitors, have shown promise for incurable or recurring instances. Even though PIMT usually has a benign history, it is important to comprehend its biological behavior and molecular foundations for precise diagnosis and efficient management. This underscores the need for additional study into the pathophysiology and potential treatments of PIMT. This report presents a case of a 53-year-old female who presented with complaints of breathlessness and chest pain and was diagnosed with the condition accidentally.

Fatty liver disease - non alcoholic to metabolic - A transition of concepts!!

Metabolic dysfunction associated fatty liver disease (MAFLD) was a concept suggested lately. Initially, the only criterion for the diagnosis of MAFLD was the absence of alcohol intake. With rising prevalence and studies assessing this condition, certain "positive criteria" were put forth. Experts from 22 countries proposed a simple yet comprehensive definition for the condition independent of other liver diseases. The presence of hepatic steatosis in addition to diabetes mellitus type 2, metabolic dysregulation, and obesity is generally observed. Criteria to define MAFLD-associated cirrhosis were also proposed. Reaching an agreement on MAFLD criteria will help define a protocol (for example: for International classification of Diseases (ICD) - coding), which will improve clinical care and advance the clinical and scientific field of liver research. As it is a condition that increases the risk of diabetes mellitus, chronic kidney disease (CKD), cirrhosis, hepatocellular carcinoma, and cardiac disorders it is important to recognize it at an early stage which makes it essential part of family medicine and primary care.

Unveiling Rare Complications: Pancreatic Pseudocysts and Monomicrobial Non-neutrocytic Bacterascites in Decompensated Cirrhosis.

One frequent side effect of chronic pancreatitis is pancreatic pseudocyst. Abdominal pain and vomiting are common complaints that the patient presents with. However, atypical manifestations of pancreatic pseudocyst still confound medical professionals worldwide, making identification challenging and ultimately increasing the risk of fatal consequences. We describe the case of a 41-year-old man who had decompensated liver cirrhosis linked to alcohol intake. The patient presented with dysphagia and yellowish skin discolouration, which, upon further investigation, turned out to be peripancreatic pseudocysts extending into the mediastinum. Diagnostic challenges arose due to the rare occurrence of a pancreatic pseudocyst located in the mediastinum. Patient was treated with a culture-sensitive antibiotic and on follow up he was doing well.

A Rare Case of Dyke-Davidoff-Masson Syndrome in an Adolescent Female.

The Dyke-Davidoff-Masson syndrome (DDMS) is an uncommon neurological disorder whose prevalence is not yet known. There have only been 21 adult manifestations of this rare brain disorder, out of around 100 cases previously documented. Diagnosis is challenging because of the complexity of radiological findings and clinical symptoms, which include ventricle dilation, hypertrophy of the cranial bones, increased pneumatization of the sinuses, and cerebral hemisphere atrophy. It can be inherited or acquired from infections, brain hemorrhage, and hypoxia during pregnancy. Usually, neuroimaging is used to diagnose it. This case study reports the case of a 17-year-old girl who had complex partial seizures at the age of 17 and right-side paralysis since she was three years old.

Reactive Thrombocytosis: A Bizarre Consequence of Splenectomy.

Platelets are blood components produced in the bone marrow and are essential in forming blood clots. Thrombocytosis refers to a condition that causes the excess production of platelets in the body. When it develops as a reaction to an infection, trauma, or surgery, it is known as secondary or reactive thrombocytosis. Although thrombocytosis is typically a self-limiting disorder, it can frequently result in hemorrhagic or thrombotic events. Extreme thrombocytosis may trigger thrombotic events. Therefore, clinicians must be aware of the complications of thrombocytosis. In this case report, a 35-year-old female, known to have portal hypertension and Budd-Chiari syndrome, presented with complaints of weakness and tingling in her hands persisting for eight days. She disclosed that she had undergone an elective splenectomy as part of her management for portal hypertension and Budd-Chiari syndrome eight days prior.

Systemic Lupus Erythematosus (SLE) and Thrombotic Thrombocytopenic Purpura (TTP) Presenting as Recurrent Strokes: A Case Report.

Thrombotic thrombocytopenic purpura (TTP) is a rare but potentially life-threatening condition characterized by fever, acute hemolysis, thrombocytopenia, renal dysfunction, and CNS dysfunction. A peripheral smear shows schistocytes because of microangiopathy. It is extremely rare for TTP and systemic lupus erythematosus (SLE) to coexist. This report details an Indian female patient's uncommon clinical presentation of TTP linked to SLE. A 52-year-old woman presented to the emergency department with complaints of altered sensorium and weakness of the right side of the body. She was initially evaluated as a case of a cerebrovascular accident. CT brain imaging revealed multiple ischemic infarcts involving both cerebral hemispheres. MRI brain confirmed the same. During further evaluation, she was found to have hemolytic anemia, thrombocytopenia, and nephrotic range proteinuria. Immunological investigations confirmed SLE. A peripheral smear revealed schistocytes, and the PLASMIC score confirmed a high risk of TTP. The patient was treated with immunosuppressants, plasma exchange, and hemodialysis, along with other supportive measures. The patient showed a positive response to the therapy mentioned, with improved power and renal function. The patient denied a renal biopsy and was discharged after two weeks. This case report emphasizes the importance of the association between TTP and SLE.

Quantitative Angiography: The Dawn of a New Era in Cardiovascular Medicine.

This comprehensive review explores the transformative role of quantitative angiography in the landscape of cardiovascular medicine. Tracing the historical evolution of cardiovascular diagnostics, we emphasize the significance of angiography in diagnosis and treatment. The primary focus on quantitative angiography reveals its capacity to move beyond qualitative assessments, providing clinicians with precise measurements and objective parameters. This paradigm shift enhances diagnostic accuracy, promising far-reaching implications for the future of cardiovascular medicine. The ability to tailor interventions based on meticulous measurements optimizes therapeutic strategies and positions the field on the brink of a new era where personalized approaches become the norm. However, challenges such as image quality, radiation exposure, and interpretation variability persist, necessitating a collective call to action for continued research and development. As we confront these issues, collaborative efforts across disciplines are essential to refine existing technologies and usher in innovative solutions. This review concludes with a resounding call for ongoing research initiatives, large-scale clinical studies, and collective commitment to propel quantitative angiography into a universally accepted standard, ensuring its full realization in enhancing patient care and outcomes in cardiovascular medicine.

Methylcobalamin Deficiency Presenting as Thalamic Syndrome in the Elderly: Association or Chance?

Vitamin deficiency is common in the geriatric population and is responsible for majorly imbalanced hematological, neurological, and neuropsychiatric functioning. Methylcobalamin deficiency or vitamin B12 deficiency can be underestimated in some cases and be misdiagnosed as other illnesses, such as thalamic syndrome. Timely diagnosis of this deficiency is essential, especially in the geriatric population, as it might cause irreversible structural brain damage. This is also presented as elevated levels of homocysteine and methylmalonic acid. Clinically, it presents with the following symptoms: lower sensitivity levels to touch and light, psychosis, paresthesia, anemia, imbalance, fatigue, cognitive disturbances, difficulty remembering, and confusion. Symptoms are usually progressive and worsen over a period of time. In this case report, we present the case of a 62-year-old male with clinical symptoms of numbness and tingling in the right side of the body. The neurological presentations resembled left thalamic infarct, but the underlying reason was methylcobalamin deficiency.

Black Digits Matter: A Multispecialty Enigma.

Introduction Digital ischemia is alike any other visceral ischemic event leading to severe tissue damage ultimately causing necrosis of the involved extremity. It's like a preview of the upcoming systemic disorder and can present itself in any specialty and hence everyone, be it a physician or a surgeon must be primed toward how to proceed with a case of digital ischemia. In this case series, we present six such cases that presented with digital ischemic events either as a sole presentation or were followed by other systemic manifestations that led to their evaluation and ultimately the etiology behind it. Material and method Patients visiting Rheumatology OPD with complaints suggestive of digital ischemia were included in this study. All patients underwent thorough history taking and clinical examination to establish the cause of digital ischemia. Patients with probable infective, trauma, cardiac, and drug-induced causes and malignancies were excluded. As per probable autoimmune causes, patients underwent evaluation via antinuclear antibodies by immunofluorescence (ANA by IF), antiphospholipid antibodies like lupus anticoagulant (LAC), anticardiolipin antibodies (AcL) and anti Beta2GP1 antibodies, extractable nuclear antigens (ENA) and in cases of suspected vasculitis doppler ultrasound and angiography.  Results Six patients were identified as cases primarily presenting with digital ischemia or with a prior history of digital ischemia. Two patients were of the pediatric age group, one 16-year-old male presenting with acute arthritis and a history of digital ischemia one year back, and the other was a 12-year-old female with blackening of the second toe in her left foot with a history of similar complaints in the left great toe for which she underwent amputation of that toe. Other four cases were of the adult age group, with two cases of scleroderma, one with systemic lupus erythematosus, and one with Takayasu arteritis. All of these patients primarily presented to departments other than rheumatology. Conclusion Digital ischemia is a pan-specialty problem with the etiologies spreading across a vast spectrum of rheumatological disorders, many of which may present to different specialties initially, later discovered to be part of the systemic manifestation of autoimmune diseases. Hence, it becomes imperative to have a rheumatological perspective in these cases of digital ischemia which all specialities should be aware of, and timely referral may prevent permanent loss of the digits and in some cases the entire limb.

Guarding Health: A Comprehensive Review of Nosocomial Infections in Sickle Cell Anemia, a Multifaceted Approach to Prevention.

This comprehensive review explores the complex dynamics of nosocomial infections in individuals with sickle cell anemia (SCA) and advocates for a collaborative strategy to enhance prevention. SCA patients, marked by compromised immunity and susceptibility to infections, face unique challenges that necessitate tailored preventive measures. The review underscores the importance of vaccination, antibiotic prophylaxis, education, and environmental hygiene in mitigating the risk of nosocomial infections. Addressing socioeconomic factors, healthcare system limitations, patient-related issues, and cultural considerations is imperative for effective prevention. The call to action emphasizes the pivotal roles of healthcare professionals, policymakers, researchers, and community engagement in implementing targeted interventions. By fostering a collective effort, this review envisions an improved landscape for infection prevention in SCA patients, enhancing their overall health outcomes and quality of life.

Navigating the Frontier: Emerging Techniques for Detecting Microvascular Complications in Type 2 Diabetes Mellitus: A Comprehensive Review.

This review comprehensively explores emerging techniques for detecting microvascular complications in Type 2 Diabetes Mellitus (T2DM), addressing the critical need for advancements in early detection and management. As T2DM continues to rise globally, microvascular complications, including retinopathy, nephropathy, and neuropathy, contribute significantly to the morbidity and mortality associated with the condition. The review synthesizes key findings, revealing various emerging technologies, from advanced imaging modalities to genomic and proteomic approaches. It underscores the potential for personalized medicine, emphasizing the importance of tailoring diagnostic strategies to individual patient profiles. Challenges, including the lack of standardized criteria and issues related to patient adherence, highlight the necessity for collaborative efforts. The conclusion issues a call to action, advocating for enhanced collaboration, increased research investment, patient empowerment through education, and seamless integration of emerging diagnostic techniques into routine clinical care. The review envisions a transformative shift in detecting and managing microvascular complications in T2DM, ultimately improving patient outcomes and contributing to a healthier future for individuals affected by this prevalent metabolic disorder.

Exploring the Impact of Security Technologies on Mental Health: A Comprehensive Review.

This comprehensive review explores the intricate relationship between security technologies and mental health. Security technologies, including physical security, cybersecurity, and surveillance measures, are integral components of our modern world, designed to protect individuals, organizations, and society from various threats. While they are vital in enhancing safety, they also have profound implications for mental well-being. The review delves into the positive impacts of security technologies, including their capacity to enhance personal safety, reduce anxiety and fear, and instill a sense of security. However, it also reveals the negative consequences, such as privacy invasion, surveillance-related stress, paranoia, and ethical concerns, which can erode mental health. User perception and trust are central to understanding how individuals experience security technologies. The review emphasizes the importance of ethical guidelines, user education, and technological advancements in mitigating negative impacts. By embracing an ethical-by-design approach, empowering users, and promoting public awareness, a balanced equilibrium between security and mental health can be achieved. The conclusion highlights the significance of ongoing research and interdisciplinary collaboration to navigate this intricate relationship effectively. By prioritizing ethical considerations and fostering a dialogue that values security and individual well-being, we can ensure a safer and more mentally healthy future in our technologically interconnected world.

A Comprehensive Review of the Immunomodulatory Effects of Vitamin D in Sepsis.

Sepsis remains a critical global health challenge characterised by a dysregulated immune response to infection, leading to systemic inflammation and organ dysfunction. This review examines the immunomodulatory effects of Vitamin D in sepsis, focusing on its regulation of immune cell function, modulation of cytokine production, and enhancement of antimicrobial responses. While the potential of Vitamin D as an adjunctive therapy in sepsis management is evident, challenges such as variability in Vitamin D status, uncertainties regarding optimal dosages and patient heterogeneity, and potential adverse effects require careful consideration. The review highlights the implications for future research and clinical practice, emphasising the need for standardised measurement protocols, elucidation of optimal supplementation strategies, and integration of Vitamin D assessments into routine care. Despite the complexities, Vitamin D emerges as a promising avenue for personalised interventions in sepsis, necessitating ongoing research collaboration and evidence-based guidelines to harness its full therapeutic potential and improve clinical outcomes.

Postpartum Hypocupric Myelopathy Masquerading as Acute Transverse Myelitis: A Case Report and Literature Review of a Rare Presentation.

The symptoms of transverse myelitis, an acute demyelinating inflammatory condition of the spinal cord, include motor, sensory, and bowel-bladder dysfunction that can develop suddenly or gradually. Several etiologies, such as bacterial, fungal, or viral infections, cancer, autoimmune diseases, vascular problems, and environmental variables, can cause it. The identification of copper deficiency myelopathy (CDM) as a curable cause of non-compressive inflammatory myelopathy has only occurred recently. Patients frequently present with sensory complaints and a spastic gait. The neurological disease may exist independently of the hematologic signs. Only a few cases of copper myelopathy in peripartum women have been documented. Given that hypocupric myelopathy is a treatable cause of debilitating paraplegia, maintaining clinical vigilance will be crucial in minimizing neurological sequelae, as demonstrated in this case report.

The Leukemoid Reaction in Severe Alcoholic Hepatitis: A Case Report.

Alcoholic hepatitis (AH) is a clinicopathologic illness caused by excessive alcohol abuse and is a precursor of cirrhosis. The leukemoid reaction (LR) is characterized by a strikingly raised granulocyte count of 40,000-50,000 cells/mm3. The LR usually suggests an acute inflammatory reaction. It is usually mistaken for chronic myeloid leukemia. The initial phase of leukocytosis occurs due to the releasing of cells from the bone marrow with more immature cells, causing a left upper shift in the ratio of immature to mature neutrophils and macrophages. The LR is usually seen in cases of leukemia but is rare to present in alcohol hepatitis. Excessive alcohol use causes AH in persons with or without underlying chronic liver disease. In severe AH, leukemoid responses have been associated with very poor prognosis and short-term mortality. We describe a case of a 35-year-old male with severe AH with an LR.

Outcome Predictors of Acute-on-Chronic Liver Failure: A Narrative Review.

Complications of acute-on-chronic liver failure (ACLF) include increased short-term mortality. Extrahepatic organ failures result from chronic liver disease and acute hepatic injury. This combination characterizes end-stage liver disease. Its rapid progression makes it challenging for hepatologists and intensivists to treat. The varied definitions of this condition lead to varied clinical presentations. Hepatic or extrahepatic failures are more prevalent in chronic hepatitis B or cirrhosis patients who receive an additional injury. Numerous intensity parameters and prognosis ratings, including those for hepatitis B virus (HBV), have been developed and verified for various patients and causes of the disease. Liver regeneration, liver transplantation (LT), or antiviral therapy for HBV-related ACLF are the main treatment aims for various organ failures. LT is the best treatment for HBV-ACLF. In some HBV-related ACLF patients, nucleos(t)ide analogs and artificial liver assistance may enhance survival. Combining epidemiological and clinical studies, this review updates our understanding of HBV-ACLF's definition, diagnosis, epidemiology, etiology, therapy, and prognosis.

Coccidioidomycosis and Histoplasmosis in Immunocompetent Individuals: A Comprehensive Review of Clinical Features, Diagnosis, and Management.

Coccidioidomycosis and histoplasmosis are endemic mycoses caused by the Coccidioides species and Histoplasma capsulatum, respectively. While these fungal infections are often associated with immunocompromised individuals, they pose significant risks to immunocompetent hosts. This review comprehensively analyzes these infections in immunocompetent individuals, focusing on clinical features, diagnostic approaches, and management strategies. The current understanding of coccidioidomycosis and histoplasmosis in immunocompetent individuals includes their clinical presentations, diagnostic methodologies, and treatment options. A literature review encompassed recent studies, clinical guidelines, and expert opinions. Data were analyzed to highlight critical aspects of the clinical manifestations, diagnostic processes, and management of these infections in immunocompetent patients. Coccidioidomycosis typically presents with pulmonary symptoms that may range from mild to severe and can include chronic and disseminated forms. Histoplasmosis also presents a spectrum of pulmonary symptoms with the potential for extrapulmonary dissemination. Diagnostic approaches for both infections involve clinical evaluation, serological tests, culture, and imaging studies. Management strategies include antifungal therapies such as fluconazole and itraconazole for coccidioidomycosis and itraconazole and amphotericin B for histoplasmosis, with treatment duration and monitoring tailored to the severity of the infection. Coccidioidomycosis and histoplasmosis can significantly affect immunocompetent individuals, with clinical presentations varying widely from mild to severe. Accurate diagnosis and appropriate management are crucial for optimal outcomes. This review underscores the importance of awareness and timely intervention in managing these endemic mycoses and highlights the need for continued research into better diagnostic and therapeutic approaches.