Background: We report the diagnosis, treatment and follow–up process of 22 cases of FUNGAL sinusitis. Methods: This case- series study was carried out on 22 patients with FUNGAL sinusitis that had treatment of endoscopy and antiFUNGAL drug. Past medical history, pathology, CT scan findings and treatment of patients were evaluated. Data analysis was done using SPSS. Findings: Twelve male (57%) and 10 female (43%) patients with the age of 16-73 years were a ssessed. Mucormycosis was seen in 18 (82%) and Aspergilosis in 4 (18%) patients. Diabetic mellitus (71%), chronic renal failure (CRF) (14.3%), and leukemia (9.6%) were reported as the most common underlying diseases. Maxillary and etmoid sinuses were the site of involvement. The most common sign was unilateral periorbital edema and proptosis (95%), and the most common symptom was unilateral change of visual acuity and cheek sensation (95%). All the patients had endoscopy surgery and treated with amphotricine B or ithraconazole and ceftrinaxone, metronidazole and vancomycine. Death was reported in 5 patients (22%) and renewed functional endoscopic sinus surgery (FESS) in 1 (4.8%). Conclusion: Functional endoscopic sinus surgery with amphotncine B or ithraconazole and follow-up are effective for FUNGAL sinusitis.

Milk thistle (Silybum marianum (L.) Gaertn) belonging to the Asteraceae family and known for its valuable secondary metabolite, silymarin. In order to get the cell suspension culture of Silybum marianum, the combination of 2,4-D and BAP hormones each with five different concentrations (0, 0.1, 1, 2 and 5 mg/L) and 3 different seedling explants (cotyledon, hypocotyl and root) was used to callus formation. High-quality callus was observed in eight different of hormone-explant combinations. Successful cell suspension culture was achieved only by using callus created from cotyledon explants treated with 0.1 mg/L 2,4-D and 5 mg/L BAP. Furthermore, the study examined the effects of 2% and 4% Serendipita indica cell wall extract as an elicitor on silymarin production in cell suspension culture at three different inoculation times (24, 48, and 72 h). After 48 h of inoculation with 2% FUNGAL extract, the highest level of silymarin (199 ppm) was observed, which was significantly different from the control (46 ppm). The silymarin content of cells increased over time through elicitation with 4% FUNGAL elicitor, while no similar pattern was observed with 2% FUNGAL extract. Based on the results, the cell wall of S. indica can significantly enhance the amount of SLM in the cell suspension culture of S. marianum.