The neglected tropical disease mycetoma can become extremely devastating, and can be caused both by fungi and bacteria; these are popularly known as eumycetoma and actinomycetoma respectively. The classical triad of the disease is subcutaneous swelling, multiple discharging sinuses and the presence of macroscopic granules. The present study aims to highlight the existing diagnostic modalities and the need to incorporate newer and more advanced laboratory techniques like pan fungal/pan bacterial 16S rRNA gene polymerase chain reaction (PCR) and sequencing, Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), rolling circle amplification (RCA), loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA). It is important for the medical team to be aware of the various diagnostic options (both existing and future), so that diagnosis of such a debilitating disease is never missed, both by clinicians and microbiologists/pathologists. The newer diagnostic methods discussed in this article will help in rapid, accurate diagnosis thus facilitating early treatment initiation, and decreasing the overall morbidity of the disease. In the Indian context, newer technologies need to be made available more widely. Making clinicians aware and promoting research and development in mycetoma diagnostics is the need of the hour.
Rhinosporidiosis is a granulomatous disease with a chronic course, the etiological agent being Rhinosporidium seeberi which usually causes the development of localized lesion in the mucosa of the nose, conjunctiva, and urethra. The disease is prevalent in South India and Sri Lanka although case reports are evident from many parts of the world like Europe, America, and Africa. In the present study, we are reporting a case of rhinosporidiosis elaborating its clinical features, diagnostic modalities, and treatment. Since R.seeberi is not a successfully cultivable organism, in vitro susceptibility of drugs remains a concern. The main focus of the present study is on molecular detection of R. seeberi which can be helpful in the future for early diagnosis and prompt treatment of such cases.
Life of a medico is becoming difficult day by day. Parents instead of being proud, now a days are scared of sending their descendants in medical colleges as they spend major part of their life juggling with books and clinical cases. Many cases of anxiety, suicidal tendency, tension headache are seen and the number is increasing day by day. They live a sedentary lifestyle. Lack of exercise leads to obesity and associated health hazards. Many of them suffer from non communicable diseases which could have been prevented by healthy diet, exercise and stress free lifestyle.
For more than two decades, antifungal susceptibility testing and interpretation haunted the medical professionals in diagnostics and management. This article mainly focuses on the three most widely used methods: broth microdilution, E test, and disc diffusion. It also focuses on the fact that clinicians should switch from empirical treatment to susceptible drugs as early as possible to combat antifungal resistance and newer mutations that horrify us every single day with poor patient outcomes. Many factors need to be taken into account during the interpretation of results but the positive side of the story is that they have been well documented in the literature. Though many methods have come up in testing antifungal susceptibility, still there is a scope for a rapid yet accurate testing modality to flourish and take the lead.
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