Disseminated invasive aspergillosis in a prolonged stay in the intensive care unit

Aspergillus is a common cause of invasive mycosis, especially in immunocompromised individuals. We report the case of a 62-year-old male who was hospitalized after suffering severe physical injuries and died after few weeks of hospitalization. A medicolegal autopsy was conducted, and various organs were sent for histopathological examination of which heart, lungs, and kidneys showed extensive involvement by aspergillus. Thus, a diagnosis of disseminated invasive aspergillosis was made on autopsy, which itself is a rare entity. This case report illustrates a prolonged stay in the intensive care unit as a possible risk factor for the development of disseminated aspergillosi

Chemiluminescence based immunoassay for the detection of heroin and its metabolites

Introduction: Continuous use of opiates causes drug-related illnesses, which poses an alarming situation to develop sensitive detection platform. In this study, a highly sensitive and reliable chemiluminescence immunoassay (CI) has been developed for the detection of heroin and its major metabolites in spiked urine samples. Methods: To develop robust immunoassay, monoacetyl morphine-bovine serum albumin (MAM-BSA) conjugate was synthesized and characterized thoroughly by physicochemical techniques. The anti-MAM antibodies were developed, labeled with horseradish peroxidase (HRP) and immunoassay was developed to detect the presence of target drug in spiked urine samples. Results: A competitive CI was developed, where heroin, MAM, morphine, and codeine concentration were ranged from 0-1000 ng/ mL in spiked urine samples and limit of detection were 80, 95, 90, 75 pg/ mL. Conclusion: The developed CI is highly sensitive, specific, point of care, cost-effective and can be used as a routine technique for quantitative analysis for screening of narcotic drugs

Disseminated invasive aspergillosis in a prolonged stay in the intensive care unit

Aspergillus is a common cause of invasive mycosis, especially in immunocompromised individuals. We report the case of a 62-year-old male who was hospitalized after suffering severe physical injuries and died after few weeks of hospitalization. A medicolegal autopsy was conducted, and various organs were sent for histopathological examination of which heart, lungs, and kidneys showed extensive involvement by aspergillus. Thus, a diagnosis of disseminated invasive aspergillosis was made on autopsy, which itself is a rare entity. This case report illustrates a prolonged stay in the intensive care unit as a possible risk factor for the development of disseminated aspergillosi

Laryngotracheal trauma management and associated morbidity & mortality: four year experience at a tertiary care centre: Laryngotracheal trauma management

AIM- Cut throat injuries pose a great therapeutic challenge because of the multiple vital structures that are vulnerable to injuries in a small, confined unprotected area. In this study, we describe the site and depth of the injury, etiology, management and prognosis. METHODS- This was a retrospective study of 18 laryngotracheal trauma patients treated at the department of ENT in MDM hospital between April 2017 and January 2020. RESULTS- out of 176 cases of penetrating neck injury, 18 patients presented with a breach in the laryngotracheal framework. Male: Female ratio was 17:1. The peak age of incidence is in the 2nd and 4th decade of life. Accidental cut throat injury was the most common mode of injury (83%) followed by homicidal (11%) and then suicidal (5%). Endotracheal intubation (where possible) or emergency tracheostomy was done to secure the airway in all the cases followed by surgical debridement, laryngeal/hypopharynx repair. Post-operative endoscopy is useful to identify complications. Wound dehiscence was the most common complication. CONCLUSIONS- Cut throat injuries are one of the common E.N.T. surgical emergency. Timely intervention is paramount because it may otherwise cause death of the patient. Securing the airway, control of hemorrhage and fluid & blood replacement is the mainstay to prevent complications like shock, sepsis, laryngeal stenosis or fistula formation