Introduction: The second wave of coronavirus disease 2019 (COVID-19) led to the resurgence of opportunistic infections due to the injudicious use of steroids. Sinonasal mucormycosis was declared an epidemic in India during the pandemic. Mucormycosis was managed effectively by surgical debridement along with systemic amphotericin B. Currently, a resurgence of mucormycosis following initial treatment, in the form of fungal osteomyelitis of the frontal bone, is being seen in India. Methods: This prospective study included 10 patients with fungal osteomyelitis of the frontal bone due to mucormycosis. All patients underwent surgical debridement of the sequestrum and involucrum, with systemic antifungal pharmacotherapy. Results: The average duration of time until mucormycosis recurrence was 22 days following initial treatment (range 10–33 days). Patients presented with extracranial bossing following outer frontal cortex erosion (n=3), bicortical erosion (n=3), bifrontal involvement (n=2), dural involvement (n=3), and involvement of the brain parenchyma and prefrontal cortex (n=2). All cases underwent debridement of the entire sequestrous bone and involucrum until normal bone could be identified. The mean admission duration was 4 weeks (range 3–6 weeks). All treated patients are currently alive and without disease, confirmed by contrast-enhanced computed tomography. Conclusion: Based on our experience, the successful treatment of fungal osteomyelitis due to mucormycosis requires a four-pronged approach: early detection, multidisciplinary management of comorbidities, surgical debridement of necrotic bone, and adequate systemic antifungal therapy.

Abstract. To achieve the superior real time fuel economy, to meet the consistent stringent automotive exhaust emissions or to ensure best energy utilization, lots of new technologies are being adopted by the automotive manufacturers and suppliers. This new technologies comes with more and more complex to the existing system. This leads to the increase in the calibration parameters and indirectly affects the calibration efforts too.In addition to this, due to the deterioration or failure of the engine components like, exhaust gas treatment devices, intake devices etc., are resulting in high emissions or unexpected uncomfortable driving for the drivers. To resolve this, there is a need for a flexible and intelligent control strategy.Currently, the available conventional control strategies use the mapping method. The calibration time is long and the work is complex when adopting this mapping method. The model based control strategies also not successful in governing the unexpected behavior in the system.Hence, a new controller based approach for an air system, based on hybrid of fuzzy logic and neural network is proposed in this research work to control the air mass, EGR (Exhaust Gas Recirculation) ratio, boost pressure and inter cooler. This new approach is designed to be implemented in a standard ECU (Electronic Control Unit) without any change in the current engine hardware design. The fuzzy logic based controller will replace the existing conventional map based PID controller. The neural network will learn the deterioration and failures of engine components and perform online calibration for the fuzzy logic controller.Thus the combination of fuzzy and neural network approach will help to avoid the high emissions and unexpected uncomfortable driving mode for the drivers. The proposed, new control approach, which uses the hybrid approach of fuzzy logic and neural network, is very easy to tune, simplify the development time, improve the control precision of the air system and reduce cost and time of calibration.

Introduction: Mucormycosis is a aggressive and most dangerous type of oppurtunistic Fungal infection. This disease starts commonly from Nose and Para nasal Sinuses. Many a times Middle Turbinate alone and some time both Middle and Inferior Turbinate are affected. This Fungi invades the Arteries more than the Veins and produce Thrombus and further reduces blood supply to concerned region and later on resulting in Necrosis of soft and Hard tissues , which was seen clinically as Black coloured “ Eschar”, the characteristic Endoscopic nding of Mucormycosis. Objectives: To Study about the effects Mucormycosis in the Turbinate, Septum and Floor of Nasal Cavity and to know the Effect of Septal Deviation in development of Sinusitis and further development of Mucormycosis. Study Design: Analytical Study, Retrospective Study. Materials And Method: This study was conducted in Govt Thanjavur Medical College, in Department of E.N.T and Head and Neck Surgery, from May 2021 to July 2021. Total Number of cases taken for study was 81 cases. Cases with Orbital and Pterygo Palatine Fossae and Infra Temporal Fossae involvement and Intra cranial involvement are excluded from the study. All cases are subjected to DNE and classied according to ndings. All cases under went Endoscopic Sinus Surgery and tissues sent for HPE and Fungal culture, followed by Systemic Amphotericin and Regular Post Operative Follow up for 4-6 weeks. Results: Males are involved more in numbers (48) than Females. Commonest age group involved are 21 to 40years. Strong Positive association present between Post Covid-19 status and Diabetes. Middle Turbinate involved in more number (34cases), followed by Inferior Turbinate (21 cases) and Septum (18 cases). Most common Anatomical factor present are High Septal Deviation (60 cases) and Osteo Meatal Complex (OMC) crowding (56 cases). Discussion: Mucormycosis is a Fulminant Fungal infection, which is common in Immunodecient individuals. Patients with Uncontrolled Diabetes Mellitus, on Prolonged Steroid therapy and Post COVID_19 status are very much prone for this infections. Angio invasion to Arteries and the resultant formation of Thrombi and Gangrene of involved areas is characteristic of Mucor. Black coloured dead tissue is called as ESCHAR. Depending upon the Arterial involvement Anterior half of Middle Turbinate or Posterior half of Middle Turbinate is involved, Posterior half of septum or entire septum is also involved. High septal deviation gives indirect disturbances to Osteo Meatal Complex functions resulting in development of Sinusitis and further chances of developing Mucormycosis. Early Surgical debridement of dead tissues followed by Inj.Amphotericin is very important in restriction of Disease spread. Proper management of predisposing factors and Postoperative Regular Weekly follow up and Endo Cleaning reduces the Recurrences. Conclusion:In our Study Males are affected more in numbers. 21-40 years are affected more. High Septal Deviation and OMC crowding are present in more number of patients which was responsible for the development of Acute Sinusitis. Post Covid status and Uncontrolled Diabetes was the commonest Predisposing factor the development of Mucormycosis. Middle Turbinate was involved more in numbers followed by Inferior Turbinate and Septum. Routine Examination followed by Nasal Septal Correction plays a major preventive role in development of sinusitis and further dreaded complications like Mucormycosis. Adequate Glycemic Control and Inj Amphotericin plays important role in the management of Mycormycosis. Regular Follow up with Endo Cleaning is reduces the chances of Recurrence.

Introduction: Corona virus disease 2019 (COVID-19) infection and its associated Bacterial and Fungal infections are more in number in this Second Wave. Among them the Mucormycosis is more in number in Post COVID-19 and during treatment of COVID-19 . Increased incidence related with usage of Steroids and Oxygen in the management of Covid19. Early Endoscopic Debridement and Inj. Amphotericin plays major role. Objectives: Study about the various Types of Mucormycosis, Iinvolvement of various Para Nasal Sinuses, Orbital involvement and its association with Steroid Usage, Oxygen Theraphy and Diabetes Mellitus and Effectiveness of Earlier Surgical Debridement. Study Design: Discriptive Study, Analytical Study. Materials And Methods: Study was conducted in Government Thanjavur Medical College, Tamil Nadu, India in MucorMycosis ward and ENT Department from May 2021 - July 2021. Total Number of patients are 241. . All cases are Evaluated, Processed, and Classied into various types. Rhino-Orbital type of cases are taken for Endoscopic Sinus Surgery followed by Amphotericin injection and discharged and followed regularly. Results: Mucormycosis of Nose and Paranasal Sinus involvement are more in numbers, followed by Rhino –Orbital Mucormycosis, and RhinoCerebral types. Pulmonary, Cutaneous and Intestinal MucorMycosis are very few only. Males are more affected. Most of the cases associated with Diabetes. Excellent Recovery and Reduced Recurrence in Earlier Surgical Debridement cases than later cases. Discussion: Sino Nasal type of Mucormycosis are more in number. Very early Diagnosis with Suspicious Clinical Symptoms and Signs and Supportive Evidence by Radiological investigation especially by MRI is very important. Earlier Surgery and Adequate Amphotericin coverage plays vital role. HPE and Fungal Culture is Essential. Glycemic Control is Mandatory for Good Results. Steroid use and Oxygen theraphy are not having Signicant relationin development of Mucor in our study. Regular weekly Follow-up, Endo- Clearance, Nasal Douching with Hypertonic Saline and Solvage theraphy with Tablet Posaconazole, and Diabetes Management Signicantly reduces the Recurrence. Conclusion: Earlier Diagnosis and Effective Surgical Debridement and Adequate Antifungal treatment and Good Glycemic Control is the Mainstay of Mucormycosis Mangement. Regular Follow-up is necessary for Reduction of Recurrence.