The study aimed to determine clinical presentation, contributing factors, medical and surgical management, and outcome of patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM). A cross-sectional, single-center study was conducted on patients receiving multidisciplinary treatment for mucormycosis following the second wave of COVID-19 pandemic from April to June 2021 in India. Clinicoepidemiological factors were analyzed, 30-day overall survival and disease-specific survival were determined, and t-test was used to determine the statistical significance. A total of 215 patients were included in the study, the cases were stratified into sino-nasal 95 (44.2%), sino-naso-orbital 32 (14.9%), sino-naso-palatal 55 (25.6%), sino-naso-cerebral 12 (5.6%), sino-naso-orbito-cerebral 16 (7.4%), and sino-naso-orbito-palato-cerebral 5 (2.3%) based on their presentation. A multidisciplinary team treated patients by surgical wound debridement and medical therapy with broad-spectrum antibiotics and amphotericin B. Across all disease stages, cumulative 30-day disease-specific survival is 94% (p < 0.001, intergroup comparison, Breslow (generalized Wilcoxon) CI 95%) and overall 30-day survival is 87.9% (p < 0.001, intergroup comparison, Breslow (generalized Wilcoxon) CI 95%) (censored). Early identification, triaging, and proper multidisciplinary team management with systemic antifungals, surgical debridement, and control of comorbidities lead to desirable outcomes in COVID-associated mucormycosis. The patients with intracranial involvement have a higher chance of mortality compared to the other group.
Study of distribution, clinical features, radiological features, histopathological aspects, management and outcomes of tumours giving rise to unilateral proptosis. This is a prospective study including 40 patients with benign and malignant tumours of orbital, paraorbital and other sites giving rise to unilateral proptosis. Final diagnosis was made following detailed radiological and histopathological examination. Then, treatment modality was decided, which included surgery, radiotherapy, chemotherapy or required combination. Proptosis was measured by simple/plastic ruler exophthalmometry method. The maximum number of cases 8(20%) were in age group 31-40 years. The youngest patient was 4 year old and the oldest was 80 years. M:F ratio was 1.85:1. Malignant tumours were 32(80%) and benign tumours were 8(20%). 12 cases were having 3 mm proptosis (minimum) and one case having 18 mm (maximum). Only 4(10%) orbital tumours were responsible for unilateral proptosis. Paraorbital tumours 34(85%) was the major cause for unilateral proptosis and 2(5%) were from distant sites. Surgery was the mainstay of treatment 14(35%), followed by combined (surgery ? radiotherapy) 5(12.5%), chemotherapy 4(10%), There was 4(10%) mortality, 16(40%) improved 3(7.5%) had same status and 17(42.5%) deteriorated. Thus nasal obstruction is the commonest ENT presenting complains in these patients. The major cause of unilateral proptosis was found to be paraorbital tumours (34%). Thus, a case of proptosis should never be ignored but a thorough ENT and ophthalmic examination is necessary. As malignancy is one of the major cause of unilateral proptosis catching and treating them early will reduce mortality.
No abstract
Aqueous, ethanolic, Benzene extracts from different developmental growth stages of pod and stem bark of C. fistula were investigated for their anthelmintic activity against the earthworm Pheretima posthuma. Different concentrations of extracts were used to determine the anthelmintic activity, which involves time of paralysis and time of death of the worm. Ethanolic young bark and aqueous old bark extracts showed very good anthelmintic activity with respect to paralysis and death time, as compared to control and standard Albendazole (2mg ml -1 ) and Piperazine Citrate (1.5 mg ml -1 ). Hence, extracts of bark and pod might be applied against the chronic infection caused by parasitic worms.
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