A middle-aged woman with diabetes presented with left-sided facial pain, complete ptosis and fever of short duration. On presentation, she had hyperglycaemia without ketosis. There was total ophthalmoplegia of the left eye with a visual acuity of 6/36. She incidentally tested positive for COVID-19. CT paranasal sinus and MRI brain revealed left-sided pansinusitis with acute infarct in the left parieto-occipital region without angioinvasion. An emergency functional endoscopic sinus procedure was done, which confirmed mucormycosis on histopathological examination. After 1 week of conventional amphotericin B and antibiotics, repeat CT brain showed improvement in mucosal thickening and sinusitis. This case is a rare presentation of mucormycosis associated with rapid progression to orbital apex syndrome with brain infarction in a patient with non-ketotic diabetes and COVID-19. Early diagnosis and treatment are essential to prevent further end-organ damage. It is also interesting that there was no angioinvasion and transient periarterial inflammation was attributed to brain infarction.

No abstract

Treatment of WISH (human amnion) cells with interferon-gamma (IFN-gamma) inhibits their growth. Release of the cells from IFN-gamma-mediated growth inhibition led to a rapid and significant increase in DNA synthesis, followed by doubling of cell numbers. The DNA synthesis profile was strikingly similar to that shown by WISH cells released from growth arrest by the G1/S phase inhibitor, aphidicolin. This strongly suggested that IFN-gamma treatment leads to growth inhibition of WISH cells at the G1/S boundary of the cell cycle. In contrast, IFN-alpha blocked growth of these cells at the G0/G1 boundary.

Chronic suppurative otitis media (CSOM) is an important cause of preventable hearing loss, particularly in the developing world. Aim: To determine the microbiological profile of CSOM and determine the antibiotic susceptibility testing of aerobic bacteria which will be beneficial for appropr iate treatment there by reducing complications. Methods and Materials: A total of 109 patients with CSOM attending outpatient and admitted inpatient in ENT department were included in the study. Two pus swabs each for infected ear were collected. Specimens were subjected to Gram stain and plated on to appropriate culture media to isolate bacterial and fungal pathogens. Bacterial and Fungal species identification and Antibiotic susceptibility testing of aerobic bacteria of isolated pathogens was done. Results: Out of 109 samples cultured there were 70 bacterial and 14 fungal isolates. Most common aerobic bacterial isolate was Pseudomonas aeruginosa (34.2%) followed by Proteus mirabilis (22.8%) and Staphylococcus aureus (17%). Among fungal isolate, Aspergillus niger (64.3%) was predominant followed by Aspergillus flavus (21.4%) and Candida species (14.3%). Amikacin (91.6%) and Ciprofloxacin(87.5%) showed maximum activity to Pseudomonas aeruginosa. The antibacterial susceptibility pattern of Staphylococcus aureus revealed 58.3% Methcillin resistant Staphylococcus aureus (MRSA) strains. Conclusions: Emergence of Pseudomonas aeruginosa as most common aerobic isolate and high incidence of Methicillin Resistant Staphylococcus aureus in present study indicates the necessity of continuous evaluation of bacteriological profile and antimicrobial susceptibility testing in all CSOM cases.