Mucormycosis: The Black Fungus
COVID-19 and The Black Fungus (informally referred to as The Black Fungus) is the new lethal complication.
• India is combating the deadly second wave of coronavirus and lately, such potentially deadly complication is being observed in patients recovering from COVID-19 all over the country and this has increased the tensions.
• Being a medical student, I’d like to elaborate this topic, and share a bit of information I have and let the plebs out there understand this in quite a simple way.
• What is mucormycosis and it’s cause?
(previously termed zygomycosis)
Mucormycosis is any fungal infection, non-contagious, typically caused by a group of molds called mucormycetes or by a fungi in order Mucorales. Can be fatal if left unattended. Mucoralean fungi are the first colonisers of dead or decaying plant material.
• There are several types of mucormycosis such as Rhinocerebral Mucormycosis, Gastrointestinal Mucormycosis, Pulmonary (lung) Mucormycosis and Cutaneous (skin) Mucormycosis and Disseminated Mucormycosis.
But the most common one, which is found in the COVID-19 patients is the Rhinocerebral Mucormycosis. The overall mortality rate is approximately 50% that rises to about 85% in Rhinocerebral Mucormycosis. There is no vaccine to prevent mucormycosis.
• What are the sources of this fungus?
Common sources of infections are from soil, damp walls on old buildings, decaying organic matter.
Recently mentioned source, that only distilled water should be used for hydrating oxygen, sometimes tap water, or any other available water, is being used either due to ignorance or negligence.
• How is it medically diagnosed?
Presumptive diagnosis is based on the patient’s history and physical examination.
Tests such as CT or MRI help defining the extent of infection or tissue destruction.
• Who’s at higher risk?
Not all people having COVID-19 obtain mucormycosis, but the most prone to getting affected may be:
- People taking immunosuppressant steroid medications to manage pre-existing illnesses as well as COVID-19, over a long period of time. Because steroids reduce immunity and push up blood sugar levels in both diabetics and non-diabetic patients.
- Prolonged ICU stay.
- People having weakened immune system because of previous organ transplant surgeries or cancer therapy procedures.
- People with HIV/AIDS, congenital bone marrow disease, diabetes mellitus are prone to developing mucormycosis.
• What are the common symptoms?
- Dark scabbing in the nose and by the eyes
- Necrotic black lesions on the hard palate
- Unilateral facial swelling or near cheekbones,
reddish skin over nose
- Sinusitis: nasal clogging or congestion with bloody or blackish mucus discharge
- Hazy vision: objects appearing blurred or in double
- Tooth ache, or pain in jawbone
- Abnormal blood clotting or thrombosis
- Black pus from eyes in case of periorbital infection.
• What should be the obvious treatment?
Once diagnosed, urgent medical care by a team of specialists including a microbiologist, internal medicine expert, neurologist, ENT Specialist, ophthalmologist, dentist should be given. It must be fast and aggressive, because the tissue damage caused cannot be reversed.
- Antifungal medications: Amphotericin B given intravenously is the usual drug of choice. Lipid formulations of amphotericin B are often used as first-line treatment.
Also, posaconazole or isavuconazole may treat mucormycosis can be given orally too.
- Surgical debridement of the infected area.
• What are serious complications?
- Blindness: in case of periorbital infection where eye is affected and vision is lost.
- Meningitis: inflammation of the membranes (meninges) that surround the brain and spinal cord.
- Pulmonary hemorrhages.
- Brain abscesses.
• Is it possible to prevent Mucormycosis?
- Good control or treatment of health problems with diabetes.
- Ensuring personal hygiene.
- Wearing face masks, face shields, gloves and all protecting equipments.
- Patients recovering from COVID-19 should stay indoors and should take extreme care.
People often sacrifice foot health for fashion, but at what cost ?
Considering the fashion of footwear in this modern era not only causes pain but also hampers the structural alignment of the body . Footwears like high heels , narrow bellies , flat slippers , narrow loafers etc has a localised effect as well as has an impact on entire posture of the body. Therefore people must know how these footwears cause various changes.
The following is an abstract that will enlighten you about various changes that your choice of footwear can make.
An attractive pair of footwear can make a perfect outfit , but with this style comes much sufferings . Even though this causes discomfort and prolonged pain , this barely stops anyone from wearing themoccasionally or daily.
When heels are been worn by women for a long period of time, their entire body weight is transferred to the forefoot which strains the calf muscles. This imposes enormous pressure on the knee.
Further upwards , a women’s body will attempt to compensate and create balance by forward rotation of the pelvis which increases curvature of lower spine .This causes the lower back to push forward and results in hollowing . To compensate the hollowing the upper back becomes concave which leads to forward posture of shoulder and neck. Therefore bad alignment and tense muscles are its biggest repercussions .
Similarly when people go for narrow bellies , flat pumps and loafers they strenuously try to adjust their toes into these kind of footwears which cause sstrain on the midfoot. This results in the “plantar fasciitis” i,e. Inflammation causing pain in the midfoot . Consequently reducing the arches of foot and causing flat foot .
Flat foot changes the weight bearing pattern of our body and hence disturbs the posture of our body. Poor posture can not only impact a person physically but also brings down an individual’s self esteem by hampering the personality.
One can consider the following recommendations before making a choice for their footwear :
● Avoid wearing high heels for prolonged period of time.
● Stretch leg muscles before and after putting them on.
● If possible go for platform heels.
● Avoid choosing pointed toe heels or flat bellies to allow our foot to breathe. ● Buy a wide variety of footwear with proper arches and gripped sole.
The Mutant strain.
Is the new variant of covid 19 lethal ?
A new variant of the coronavirus is spreading across the globe. It was first identified in the United Kingdom, where it is rapidly spreading, and has been found in multiple countries. Viruses mutate all the time, often with no impact, but this one appears to be more transmissible than other variants—meaning it spreads more easily. Barely one day after officials announced that America’s first case of the variant had been found in the United States, in a Colorado man with no history of travel, an additional case was found in California
Increased transmissibility can wreak havoc in a very, very short time—especially when we already have uncontrolled spread in much of the United States. The short-term implications of all this are significant, and worthy of attention, even as we await more clarity from data. In fact, we should act quickly especially as we await more clarity—lack of data and the threat of even faster exponential growth argue for more urgency of action. If and when more reassuring data come in, relaxing restrictions will be easier than undoing the damage done by not having reacted in time.
To understand the difference between exponential and linear risks, consider an example put forth by Adam Kucharski, a professor at the London School of Hygiene & Tropical Medicine who focuses on mathematical analyses of infectious-disease outbreaks. Kucharski compares a 50 percent increase in virus lethality to a 50 percent increase in virus transmissibility. Take a virus reproduction rate of about 1.1 and an infection fatality risk of 0.8 percent and imagine 10,000 active infections—a plausible scenario for many European cities, as Kucharski notes. As things stand, with those numbers, we’d expect 129 deaths in a month. If the fatality rate increased by 50 percent, that would lead to 193 deaths. In contrast, a 50 percent increase in transmissibility would lead to a whopping 978 deaths in just one month—assuming, in both scenarios, a six-day infection-generation time.
Transmissibility increases can quickly—very quickly—expand the baseline: Each new infected person potentially infects many more people. Severity increases affect only the infected person. That infection is certainly tragic, and this new variant’s lack of increase in severity or lethality thankfully means that the variant is not a bigger threat to the individual who may get infected. It is, however, a bigger threat to society because it can dramatically change the number of infected people. To put it another way, a small percentage of a very big number can easily be much, much bigger than a big percentage of a small number.
I dismissed the news initially because viruses mutate all the time and there have been too many baseless “mutant-ninja virus” doomsaying headlines this year. The exaggerated, clickbaity alarmism makes it harder to discern real threats from sensationalism. Given the constant reality of mutation, genomic variants should be considered innocent until proved guilty. Even an increase in the proportion of cases attributable to a particular variant is not definitive proof of an evolutionary advantage.
However, as data on the new variant roll in, there is cause for real concern. Trevor Bedford, a scientist at the Fred Hutchinson Cancer Research Center and a board member for the Covid Tracking Project at The Atlantic, points out that infections from the new variant are increasing very rapidly among the population in the U.K. Bedford also notes that this new variant seems to have a higher secondary-attack rate—meaning the number of people subsequently infected by a known case—compared with “regular” COVID-19. Finally, the new variant seems to result in higher viral loads (though this is harder to be sure about as viral loads can be affected by sampling bias and timing). As Kucharski told me, all of this does not rule out other explanations. This increased transmission could be due to chance or founder effects—meaning one variant just happened to get somewhere before the other variants and then got “lucky”; it was early, rather than more transmissible. It could be due to changed behavior among people—quarantine fatigue, less masking—leading to more rapid spread. However, given the current evidence, along with the specifics of the mutation, it’s getting harder to assume that those other explanations are more likely than the simple proposition that this is truly a more transmissible variant.
MRI Scan at ₹50
MRI Scan at ₹50: ‘Cheapest’ Diagnostic Facility
Gurudwara Bangla Sahib, located in Delhi, is one of the most well-known religious places. This peaceful place of solace is visited by almost more than a thousand people in one single day. And at this peaceful shrine the country’s “cheapest” diagnostic facility will be implemented from the first week of December. An MRI here will cost just ₹50, according to Delhi Sikh Gurudwara Management Committee. This seems to be great news for all of us, especially to needy people. Right!!
A dialysis centre is being set up at Guru Harkishan Hospital on Gurudwara premises. The procedure of dialysis will cost only ₹600. You would be astonished to know that machines worth 6 crore were donated to the hospital. These include machines for dialysis, machines for ultrasound, X-Ray and MRI. For needy people the cost will be low but for others the cost will be a little bit high. A committee of doctors would be set up for this practice.
During this pandemic period the cost of all these tests are increased in private laboratories. So, where will the needy go? But, Sikh Community has come up with the solution to this problem. Whether it’s a natural calamity, a protest, or a pandemic, the Sikh Community always comes in front to help humanity. Besides setting these machines at a cheap cost, they have provided food to the needy during the lockdown, given shelter to migrants who stuck in the cities, and converted gurudwara into quarantine centers. Now, to help underprivileged with diagnostic facilities they have started this. A good initiative taken by them I must say!
Main point is that it will be open for 24/7 even on national holidays, so anytime you can access their facility. If you are needy and don’t have income for private hospitals then just catch the “cheapest” diagnostic facility of Gurudwara Bangla Sahib. Anyone can access this facility, no barrier is there. I am feeling so overwhelmed that people’s donations are utilized so wisely. Charity is the most auspicious act we all should do.
“After all Humanity is the most superior and comes first. Keep helping people who are in need, don’t stop. It is like that you could feel that you are at the side of god, from earth. The most beautiful feeling of the world.”
I have only heard that ‘Sikh seva is the best seva.’ But now I have seen it also. Good deeds would fetch you good results. So, keep going and help the needy, just like Sikh.
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