phenylephrine-hydrochloride and Diabetes-Mellitus--Type-2

Rhinocerebral mucormycosis (RCM) is a rare, fulminating opportunistic fungal infection caused by a fungus of order Mucorales. These fungi are ubiquitus, subsisting on decaying vegetation and diverse organic material. Although fungi and spores of Mucorales show minimal intrinsic pathogenicity towards normal person, they can initiate aggressive and fulminating infection in immunocompromised host. Since RCM occurs infrequently, it may pose a diagnostic and therapeutic dilemma for those who are not familiar with its clinical presentation.. We present a patient with classical presentation of RCM involving paranasal sinuses, orbit, and cranial base who was treated by combination of aggressive surgical and medical therapy.. The purpose of this paper is to draw attention to the clinical presentation and pathogenesis of RCM and to emphasize need for high index of suspicion in diagnosis and treatment.

Topics: Amphotericin B; Antifungal Agents; Combined Modality Therapy; Debridement; Diabetes Mellitus, Type 2; Diabetic Ketoacidosis; Fatal Outcome; Female; Humans; Infusions, Intravenous; Lip Diseases; Maxilla; Middle Aged; Mouth Diseases; Mucormycosis; Nose; Nose Diseases; Opportunistic Infections; Orbital Diseases; Paranasal Sinus Diseases; Tomography, X-Ray Computed

Diabetes is a major health problem in both industrial and developing countries, and its incidence is rising. Although detection of diabetes is improving, about half of the patients with Type 2 diabetes are undiagnosed and the delay from disease onset to diagnosis may exceed 10 yr. Thus, earlier detection of Type 2 diabetes and treatment of hyperglycaemia and related metabolic abnormalities is of vital importance. The objectives of the present study were to examine urine samples from Type 2 diabetic patients and healthy volunteers using the electronic nose technology and to evaluate possible application of data classification methods such as self-learning artificial neural networks (ANN) and logistic regression (LR) in comparison with principal components analysis (PCA). Urine samples from Type 2 diabetic patients and healthy controls were processed randomly using a simple 8-sensors electronic nose and individual electronic nose patterns were qualitatively classified using the "Approximation and Classification of Medical Data" (ACMD) network based on 2 output neurons, binary LR analysis and PCA. Distinct classes were found for Type 2 diabetic subjects and controls using PCA, which had a 96.0% successful classification percentage mean while qualitative ANN analysis and LR analysis had successful classification percentages of 92.0% and 88.0%, respectively. Therefore, the ACMD network is suitable for classifying medical and clinical data.

Topics: Aged; Blood Glucose; Body Mass Index; Breath Tests; Diabetes Mellitus, Type 2; Fasting; Female; Glycosuria; Humans; Logistic Models; Male; Middle Aged; Neural Networks, Computer; Nose; Odorants; Proteinuria; Sensitivity and Specificity

A 63-year-old diabetic man presented with sinusitis with orbital and intracranial signs progressing over one week, due to zygomycosis. Despite control of the diabetes, surgical excision of infected tissue and antifungal therapy he died in the fifth week of illness. Pathological study showed extensive fungal infiltration of periorbital structures and mycotic thrombosis of many blood vessels with associated necrosis and infarction of fat and extraocular muscles.

Topics: Diabetes Mellitus, Type 2; Fungi; Humans; Lymphadenitis; Male; Meningitis; Middle Aged; Mycoses; Nose; Nose Diseases; Orbit; Orbital Diseases