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This study describes the clinical features, diagnosis, and treatment of rhinosporidiosis of the eye and its adnexa in a series of 76 cases in Nepal and six originating in India. The disease caused by the fungus Rhinosporidium seeberi was seen most frequently in young children between eight and 10 years of age. Males were infected more than females (2.5:1). The conjunctiva was the most common site of infection in 76 (92.68%) of the cases. The lacrimal sac was affected only in six (7.32%) cases. Simple total excision of the conjunctival polyps gave highly satisfactory results in cases of conjunctival sac infections. Except for one patient, there were no recurrences in the76 cases. Meticulous excision of polyps provided a satisfactory result in the treatment of six cases with lacrimal sac infection. Recurrence was noted in one of these six cases followed up to two and a half years after surgery. The conditions diagnosed clinically were confirmed by histopathology. This review of 82 cases is the first such report of rhinosporidiosis from Nepal.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, 2019-nCoV) emerged in December 2019 and spread into a worldwide pandemic. More than 260 million people worldwide have been verifiably infected with Sars-CoV-2 (as of December 2021), with more than 5.2 million deaths. The number of human coronavirus disease 2019 (COVID-19) cases continues to rise as countries roll out their vaccine programs. There is a broad range of clinical presentations of COVID-19, including neurological manifestations [1]. It is estimated that 10%-30% of COVID-19 patients develop neurological symptoms in the acute phase, which may be the presenting sign. Neurological manifestations of COVID-19 include cerebrovascular disorders, including ischemic stroke and macro/microhemorrhages, encephalopathies and (meningo-)encephalitis, para-/postinfectious immune-mediated complications such as Guillain-Barré syndrome, movement disorders, and neuropsychiatric complications [2-4]. In parallel to the

Objective To investigate the safety and efficacy of N-acetyl-l-leucine (NALL) on symptoms, functioning, and quality of life in pediatric (≥ 6 years) and adult Niemann–Pick disease type C (NPC) patients. Methods In this multi-national, open-label, rater-blinded Phase II study, patients were assessed during a baseline period, a 6-week treatment period (orally administered NALL 4 g/day in patients ≥ 13 years, weight-tiered doses for patients 6–12 years), and a 6-week post-treatment washout period. The primary Clinical Impression of Change in Severity (CI-CS) endpoint (based on a 7-point Likert scale) was assessed by blinded, centralized raters who compared randomized video pairs of each patient performing a pre-defined primary anchor test (8-Meter Walk Test or 9-Hole Peg Test) during each study periods. Secondary outcomes included cerebellar functional rating scales, clinical global impression, and quality of life assessments. Results 33 subjects aged 7–64 years with a confirmed diagnosis of NPC were enrolled. 32 patients were included in the primary modified intention-to-treat analysis. NALL met the CI-CS primary endpoint (mean difference 0.86, SD = 2.52, 90% CI 0.25, 1.75, p = 0.029), as well as secondary endpoints. No treatment-related serious adverse events occurred. Conclusions NALL demonstrated a statistically significant and clinical meaningfully improvement in symptoms, functioning, and quality of life in 6 weeks, the clinical effect of which was lost after the 6-week washout period. NALL was safe and well-tolerated, informing a favorable benefit-risk profile for the treatment of NPC. Clinicaltrials.gov identifier NCT03759639.