Mucormycosis is a rare infection which is largely diagnosed in immune-compromised patients. The infection can cause pulmonary, rhinocerebral, skin and soft tissue, central nervous system, gastrointestinal and disseminated disease, with gastrointestinal involvement being the rarest presentation. Outcome and mortality of zygomycosis varies with the underlying condition and site of infection, it is however very high in general. Diagnosis is usually delayed and delay in initiation of amphotericin B treatment leads to poor outcome. We report rare case of a malnourished young adult who presented with gastric perforation peritonitis due to mucormycosis infection.

Introduction: Breast abscess is a localised collection of purulent material within the breast, which can be a complication of mastitis. In women of reproductive age, these are predominantly lactational but non-lactational abscesses are also seen in premenopausal women. Abscesses generally require drainage in conjunction with antibiotics. For the treatment of breast abscesses, surgical incision and drainage are usually carried out under general anaesthesia, as a traditional method. Aim: To compare conventional incision and drainage versus open drainage with primary closure with negative suction drain modalities of treatment of breast abscess in terms of different aspects including duration and quality of healing, number of dressings required, length of hospitalisation, postoperative complications. Materials and Methods: The present study was a randomised study conducted in the Department of General Surgery, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. There were 30 patients in group A undergoing open drainage with primary closure with negative suction drain and 30 patients in group B undergoing conventional incision and drainage. They were evaluated for the study period of 18 months, between October 2018 and April 2020. The data collected were analysed with Statistical Package for the Social Sciences (SPSS) version 17.0. Results: The incidence of breast abscess was more common in age group of 21-30 years with right side affected more than left side. Both the surgical procedures were comparable with each other in terms of incidence of recurrence. The primary closure group fared better with less incidence of postoperative pain (duration of analgesics requirement 2.40 vs 5.43 days), reduced hospital stay (3.63 vs 6.67 days) and dressings requirement was also less (2.33 vs 12.27 days) compared to standard incision and drainage drainage which were statistically significant. Conclusion: Hence, it can be concluded that open drainage with primary closure with negative suction drain placement can be considered as a safe and effective alternative to the standard incision and drainage in patients with breast abscess.

BACKGROUND The present study was undertaken to test the reliability of admission test to identify compromised foetuses and to correlate the test results with different parameters of adverse foetal outcome and mode of delivery. MATERIALS AND METHODS An admission Foetal Heart Rate (FHR) tracings was obtained by cardiotocogram on 100 antenatal mothers, both high and low risk in early labour for 20 minutes and then categorised based on RCOG criteria for interpretation of admission test. Perinatal outcome and mode of delivery were analysed with the help of Kruskal-Wallis chi square test. RESULTS 1. Preeclampsia was the most common high risk factor in our study. 2. Mean gestational age at delivery in high risk group was 37 weeks compared to 39 weeks in low risk group. 3. The percentage of LSCS is more in non-reactive tracings, but this value is not statistically significant as p value is 0.0524 in high risk group and 0.0636 in low risk group. 4. In high risk category in non-reactive group, 6 out of 9 i.e. 66.7% had low Apgar score making the p value 0.0001, which is statistically significant. 5. The duration of hospital stay was also more in babies with non-reactive tracings, a mean of 7 days as compared to 5 days in reactive group in high risk patients. This value is statistically significant as the p value is 0.04. 6. The specificity of admission test in predicting perinatal mortality in high risk pregnancies is quite high; it is 95% and the negative predictive value is 93%. The sensitivity of the test is 70% and positive predictive value is found to be 78%. CONCLUSION By analysing our study carefully and comparing it with similar studies in literature we can conclude any non-reactive tracings should be extended for 40 minutes along with foetal stimulation to reduce the false positive rates. Admission test increases the rate of LSCS in both high and low risk groups. Non-reactive traces in both high and low risk groups are associated with more foetal distress, low Apgar, prolonged NICU care and increased perinatal mortality.

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