Introduction: Rhino-cerebral Mucormycosis (RCM), in the pre-Coronavirus Disease-2019 (COVID-19) era, was thought to be solely associated with an immunocompromised state. However, an unforeseen outbreak in the number of mucormycosis cases was seen with the increase in Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection. Aim: To study and investigate the clinical characteristics, imaging findings, associated risk factors, and clinical outcomes in COVID-19 associated mucormycosis. Materials and Methods: A retrospective cohort study was conducted comprising 480 cases of COVID-19 associated mucormycosis who presented to the institution between April 2020 and September 2020. The clinical and radiological data were studied and analysed. Results: Out of a total of 480 cases, 443 (92.29%) were found to suffering from diabetes mellitus and 392 patients (81.66%) had a history of steroids intake in the studied population. Facial or per orbital swelling followed by pain were the most frequent presenting complaints found in 188 (39.16%) and 162 (33.75%) patients, respectively. Nasal septum and middle turbinate were the most common sites of disease involvement on nasal endoscopic examination. On radiological imaging, maxillary (438; 91.25%) was the most commonly involved sinus followed by ethmoids (395; 82.29%). Premaxillary/retroantral fat and orbits were the most common sites of extra sinonasal spread of infection found in 278 (57.91%) and 244 (50.83%) patients, respectively. About 238 (49.58%) patients showed bony erosion and dehiscence. Intracranial complications were seen in 73 (15.21%) patients. Glycated Haemoglobin (HbA1c) levels showed significant value with higher disease staging. Oxygen supplementation was frequently associated with extrasinus spread of infection. A total of 44 (9.17%) patients succumbed to death despite aggressive antifungal treatment. Conclusion: COVID-19 associated RCM shows frequent and extensive spread to extrasinus regions, especially with uncontrolled diabetes mellitus, steroid administration, and oxygen supplementation. High clinical suspicion, early imaging, and prompt institution of antifungal therapy can aid in reducing mortality rate.

Thyroid gland is one of the most common gland affected during pregnancy as it responds to the increased physiological demands of iodine and energy during pregnancy. Any thyroid dysfunction can result in abortion, preterm labor or affects fetal neurodevelopment. Various anthropometric factors or genetic factors apart from iodine intake are known to affect the size of thyroid gland. Changes in thyroid gland morphology can be easily measured using ultrasonography as clinically the enlargement can be labelled as goiter. In this review, we aimed to evaluate the changes in thyroid gland during pregnancy and assess the different factors affecting its size across the various studies as the literature data concerning the thyroid gland enlargement during pregnancy is controversial. Various articles on thyroid volume changes during pregnancy from literature were reviewed along with a cross-sectional observation done in a government hospital setup in India, on 240 patients who were divided into 4 groups of 60 patients each which included non-pregnant females in group 1 and pregnant females in all three trimesters respectively in the rest 3 groups. Thyroid gland morphology and its characteristics such as volume, nodularity, echogenicity and vascularity were measured using high frequency ultrasonography in each group and then compared. Thyroid volume in the third trimester group (7.24±1.16 ml) was found to be significantly greater (p<0.001) than in the non-pregnant group (5.44±0.82 ml). BMI was found to be the highest in third trimester group as expected. Even in iodine sufficient areas we found thyroid gland volume to increase during pregnancy from non-pregnant group along with thyroid gland nodularity. Vascularity assessed based on CDFS pattern shows pattern I to be most common. Variation in thyroid gland characteristics between pregnant and non-pregnant controls was found.

Introduction: Continuous stimulation of thyroid gland occurs during pregnancy in order to meet the demands of growing foetus. This might result in variations in thyroid gland morphology which may be misdiagnosed if not assessed accurately. Ultrasonography can measure these variations during pregnancy in the form of change in volume, echotexture, nodularity etc. Aim: To compare the thyroid volume and nodules using ultrasound, amongst different trimesters of pregnancy and with non pregnant women of similar age and find the correlation with different factors. Materials and Methods: A time-bound, hospital-based, crosssectional observational study was done in the Department of Radiodiagnosis, Maharaja Yeshwantrao (MY) Hospital, Indore, Madhya Pradesh, India, from April 2021 to August 2022 on 240 patients. All subjects were divided into groups of 60 women each, which included non pregnant women in group 1 and pregnant women during each trimester in rest three groups, as group 2, 3 and 4, respectively. Thyroid volume and nodules were measured in each group. The descriptive data was calculated using mean and standard deviation and then compared using Analysis of Variance (ANOVA) test. Linear regression analysis was also used to assess the correlation. Results: Most 125 (52%) of the women belonged to the younger age group i.e., 21-25 years. Majority i.e., 114 (47.5%) of pregnant women were primigravida. Mean total thyroid volume in non pregnant group, 1st trimester group, 2nd trimester group and in 3rd trimester group were 5.44±0.82 mL, 5.85±0.64 mL, 6.25±0.67 mL and 7.24±1.16 mL, respectively, with up to 24% increase of thyroid volume during the course of pregnancy (p-value=0.001). Thyroid nodule incidence was 12.2% in pregnant women and 5% in non pregnant women. Conclusion: With pregnancy, there is an increase in thyroid gland size along with a small increase in thyroid nodularity. Also, the interplay of a few factors such as Body Mass Index (BMI), parity, age etc., was noted.