To assess the common presentation and extent of disease involvement clinically and radiologically and treatment modalities, sequalae of the disease, complications and treatment response. Mucormycosis is a life-threatening infection that most commonly affects immunocompromised individuals and an exponential increase in the incidence of Rhino-orbital-cerebral mucormycosis was witnessed in the second wave of the COVID-19 pandemic, despite aggressive multimodal treatment carries a significant risk of mortality. A high index of suspicion is required in order to begin the appropriate diagnostic workup and treatment. This study is conducted to access the outcome and management of mucormycosis in post covid 19 patients. The prospective study includes 180 Patients, who are attending to E.N.T. outpatient department, Triage and patients referred from other departments who had suspected/confirmed Rhino-orbital-cerebral mucormycosis/underwent surgery and/or medical treatment or both. In our study mucormycosis predominantly affected age group between 40 and 60 years, more common in males (77.8%) than females (22.2%), 77.8% patients had post covid status. Most common risk factor was diabetes mellitus.76% patients had undergone endoscopic/open surgery and 24% patients underwent only medical treatment. Among 138 patients operated, 40% had recurrence and mortality was 16.1% (significantly reduced). Early diagnosis and prompt intervention is paramount to reduce morbidity and mortality. Liposomal Amphotericin B is most effective antifungal with manageable side effects. Patients who underwent Radical debridement either endoscopically or open approach, had better outcome with minimal recurrence rates. Combined medical and surgical treatment has better outcome, lesser recurrence and mortality.

THE occurrence of hyperthyroidism and hyperparathyroidism in the same patient is a rarity and presents a specially interesting diagnostic problem since both diseases can cause loss of calcium from the body. Such a problem is presented here; there are 17 previously documented examples i n the literature (Breuer and McPherson, 1966). CASE REPORTMrs. E. S., aged 32, first presented with acute bronchitis in March, 1967, when hypercalcaemia was detected on routine investigation. There was an additional history of insomnia, weight-loss, loose motions, and irritability. I n June, 1967, she was admitted again with a diagnosis of hyperthyroidism which was confirmed on investigation.Examination revealed a thyroid enlargement estimated at 40 g., firm and with no bruits to be heard. Investigations revealed the following: FBI, 11.1 pg. per IOO ml.(normal 3'5-7'5 pg. per IOO d.); PBI3lI (48 hours), 1.07 per cent (normal 0.1-0.4 per cent); T. index (Russell Fraser), 53.2 (normal 2.8-13.0); 1311 uptake, neck uptake (48 hours), 70.8 per cent; thyroid antibodies, negative; serum calcium, 5.7 mEq. (mean of six estimations) (normal, 4'5-5.5 mEq.). The hypercalcaemia was not suppressed by cortisone administration; her serum calcium values at the end of 10 days (150mg. per day) remained higher than her previous level. Serum inorganic phosphorus was 1.7 mg. (mean of six estimations) (normal 1.6-2.4 mg.); alkaline phosphatase, 9 King-Armstrong units (normal 4-11); strontium space, 19'5 plasma units (normal (18); phosphate excretion index, basal + 0.07, +0.13 (normal *o.og); urinary calcium, 25 mEq. in 24 hours (normal

<p class="abstract"><strong>Background:</strong> Tracheostomy is one of the commonest operations performed by an otorhinolaryngologist for various indications and in different age groups and tracheo-bronchitis is a common complication in tracheostomised  patients. This study designed to determine the bacterial flora and antibiotic sensitivity of lower respiratory tract following tracheostomy in hospitalized patients.</p><p class="abstract"><strong>Methods:</strong> This is a descriptive study of 50 tracheostomised patients carried out from December 2017 to May 2019, at VIMS Ballari.  </p><p class="abstract"><strong>Results:</strong> Stridor was the most common indication for tracheostomy (70%). Tracheal aspirate was sent for bacterial culture and sensitivity on day 0, 1 week and 3 weeks post tracheostomy. Majority of the patients showed no growth in the day 0 and 3weeks post tracheostomy bacterial cultures of the tracheal aspirate. Bacterial cultures yielded growth in majority of the patients in the 1-week post tracheostomy cultures. The sensitivity pattern, intermediate response pattern and resistance pattern to the first line antibiotics that are regularly used in our hospital were studied in all the 3 samples of tracheal aspirates that were sent for bacterial culture from all the 50 tracheostomised patients.</p><p class="abstract"><strong>Conclusions:</strong> It is a good practice to send the tracheal aspirate for culture and sensitivity following Tracheostomy. If the patient is started on suitable antibiotics based on the culture postoperative recovery will be hastened, risk of postoperative infections like tracheitis, tracheobrochitis, stoma site infection and other lower respiratory tract infections can be reduced.</p>

<p class="abstract"><strong>Background:</strong> Ludwig’s angina is a potentially life threatening infection characterized by a rapidly progressing, bilateral gangrenous cellulitis of all the three primary mandibular spaces namely submental, submandibular and sublingual. If left untreated the cellulitis can progress swiftly to produce obstruction of airway and death. Despite that, no specific guidelines exist and management is greatly dependent on clinical judgement and experience.</p><p class="abstract"><strong>Methods:</strong> Forty cases of patients with Ludwig’s angina, attending the department of otorhinolaryngology were included in this study and were randomly allocated into conventional incision (CI) and multiple incisions (MI) groups. Following informed written consent, either conventional incision or multiple small incisions were used for drainage and the outcomes analysed.  </p><p class="abstract"><strong>Results:</strong> The mean age of patients was 28.4 years and majority of the patients belonged to 20-40 years age group. Male to female ratio was 2.3:1.The most common etiology was odontogenic. The outcome of both the conventional group and multiple small incisions group were comparable. The mean hospital stay of the conventional group was 10.25 days and multiple incisions group was 5.31 days which was statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> Multiple small incisions for the drainage of Ludwig’s angina is a safe and less invasive alternative method, with the advantages being shorter hospital stay and better cosmesis without an increase in complications.</p>