Background In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. Methods We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. Results Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45–59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. Conclusions Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.

Background: This is a case study of 70 cases admitted in our hospital post covid-19 infection with different complaints and signs and symptoms indicating Rhino-Orbital-Cerebral-mucormycosis (ROCM). Materials and Methods: All the cases were again screened for COVID infections and comorbidities like Diabetes mellitus, Hypertension or any other immunocompromised state. The level of involvement like nasal cavity, septum, turbinates, sinuses, pterygopalatine fossa, palate, orbit or any cerebral involvement was noted and the protocol of medical and surgical management was decided in accordance to that. Post surgery KOH mount and HPE report, CT and MRI findings were the major pillars in this regard. Results: In 100% of cases we did middle meatus antrostomy with partial middle turbinectomy and in 57% cases we did medial maxillectomy with Modified Denker’s.Rest middle meatus mega antrostomy with ethmoidectomy with partial middle turbinectomy & full house FESS was done in 21% of cases. Conclusion: The first step in the management of mucormycosis is to have a high index of clinical suspicion especially in those with COVID- 19 who have diabetes mellitus, and who have received systemic corticosteroids while on treatment.

Achalasia cardia (AC) is one of the rarely seen disorders of esophagus motility which happens as a result of degeneration of neurons which is irreversible. Treatment is mainly of palliative nature, and no complete curative treatment is available as of now. The diagnostics and therapeutics in this direction has strengthened mainly due to high-resolution manometry and per-oral endoscopic myotomy, referred to as Peroral endoscopic myotomy (POEM).The characterization of type of achalasia cardia is made easier by high-resolution manometry as we have mentioned, which also has an important therapeutic role. Achalasia has to be managed for each patient individually, and the role of pneumatic balloon dilatation, POEM, or Heller’s myotomy needs to be reconsidered. In our case report and brief review, we discussed the main aspects of diagnosing an OPD-based patient and a brief review of achalasia cardia.