<p><strong>Background: </strong>During COVID-19 pandemic, patients with diabetes mellitus (DM) and immunocompromised condition were at risk of opportunistic infections among which mucormycosis came with most dreadful consequences. Mucormycosis is a potential life-threatening, opportunistic fungal infection caused by fungi belonging to the order mucorales. Most vulnerable patients at risks are observed to be patients with uncontrolled blood sugar and diabetic ketoacidosis (DKA), patients with immunocompromised state, severe neutropenia in viral infections, on steroid therapy, oxygen therapy, chemotherapy. Despite aggressive and disfiguring surgeries paired with antifungal therapy, the mortality and morbidity rate are high. The mentioned epidemiological factors were observed and correlation between these were analysed to avoid the predisposing factors in future.</p><p><strong>Methods: </strong>The study was conducted over 160 patients as prospective cross-sectional design, admitted in mucor ward of NSCB and MCH, Jabalpur. Patients were assessed clinically with related investigations. Consent was taken after explaining the nature and purpose of study.</p><p><strong>Results:</strong> In our study, mucormycosis was found to affects elderly males more commonly, with immune-compromised state especially in diabetic population, received unsupervised steroid or oxygen therapy in unhygienic setups.</p><p><strong>Conclusions:</strong> To ensure better outcome, along with early surgical intervention and medical management, environmental predisposing factors must be taken care of. Immunocompromised state especially uncontrolled diabetes and acidosis should be corrected, judicial use of steroids, healthy life style, oxygen supplementation with aseptic masks and tubings, use of distilled water in humidifiers, immunity build-up may bring a major change in prognosis.</p>

Background: Intraventricular hemorrhage (IVH) is commonly seen in preterm infants. The aim of this study was to look at the effect of antenatal magnesium sulphate administration and milking of umbilical cord during delivery in the incidence of IVH in preterm infants.Methods: A randomized controlled study was conducted in the year 2015 on 80 preterm infants born less than 33 weeks of gestation during the study period. Magnesium sulphate was administrated to 25 pregnant women who were at imminent risk for delivery. Fourteen infants underwent milking of umbilical cord. The primary outcome was IVH detected in cranial ultrasound of day 28.Results: The primary outcome showed only 1 infant who received magnesium sulphate developed IVH, whereas 3 infants with no intervention done developed IVH. None of the preterm infants who had undergone milking of umbilical cord developed IVH.Conclusions: It was found that both antenatal administration of magnesium sulphate and milking of umbilical cord during delivery in preterm infants resulted in a significant reduction in the incidence of IVH. Further studies using more number of samples are required to understand the role of the interventions for long-term implications.

<p class="abstract"><strong>Background:</strong> In the COVID era, when self treatment and social media treatment gained popularity, diagnosis of suppurative infections was delayed and rampant misuse of antibiotics significantly increased. Hence this study is necessary to enlighten the current trend of organisms causing suppurative head and neck infections and their presentation.</p><p class="abstract"><strong>Methods: </strong>Prospective observational study in 110 patients with suppurative head and neck infections who came to Department of Otorhinolaryngology and Head And Neck Surgery of NSCB Medical College, Jabalpur within a period of 18 months ie from March 2020 to August 2021.After detailed clinical examination, under strict aseptic precautions, sample was collected and sent for investigations.</p><p class="abstract"><strong>Results: </strong>Of 110 patients, 75 were male and 35 were female, maximum in their fourth to fifth decade of life. Diabetes the most common risk factor. The commonest symptom of presentation was swelling, being maximum in submandibular area. Odontogenic the most common etiology. Submental and submandibular space infections presenting as Ludwig’s Angina is the commonest space infection. Prior antibiotic history before visit to our hospital seen in 61.8%, still only 22.8% were sterile.61.8% showed bacterial growth,10.9% fungal and 4.5% tubercular. Psuedomonas aeruginosa was most commonly isolated with site predilection to oral cavity followed by E. coli.</p><p class="abstract"><strong>Conclusions: </strong>Public education about head and neck infections, oral hygiene, non-communicable diseases should be implemented as step of primordial prevention. Culture specific antibiotic therapy for the correct amount of time should be mainstay of treatment. Prescription by a registered medical practitioner must be made mandatory for providing antibiotics to any layman to reduce the rampant overuse and misuse of antibiotics</p>

<p><strong>Background:</strong> Hypokalemia is one of the most common electrolyte disturbances seen in clinical practice and in patients receiving liposomal-amphotericin B (L-AMB). The aim of this retrospective study was to examine the prevalence of hypokalemia in patients of post COVID-19 mucormycosis receiving L-AMB and to evaluate common presenting symptoms of hypokalemia in them.</p><p><strong>Methods:</strong> The present study was conducted as a retrospective study on 100 patients of post COVID-19 mucormycosis who received L-AMB for 1^st time between May 2021 and August 2021 at department of otorhinolaryngology and head and neck surgery, Netaji Subhash Chandra Bose medical college and hospital, Jabalpur, Madhya Pradesh, India.                                                                                                                  </p><p><strong>Results:</strong> In the present study, hypokalemia of varying grades occurred in 23% of the patients, making it an adverse event that requires attention and correction. Hypokalemia is reported in middle aged adults, more in males compared to females and at doses less than 2 gm of L-AMB. Majority (91.30%) of the patients of mucormycosis who developed hypokalemia presented with generalized weakness, anorexia and muscle cramps followed by nausea which is seen in 82.60% patients. Constipation, bloating and abdominal pain being other presenting symptoms in them seen in 56.50%, 56.50% and 52.20% patients respectively.</p><p><strong>Conclusions:</strong> Hypokalemia is a common electrolyte disorder occurring in patients receiving L-AMB which if undetected can be life threatening. Adequate medical management of these patients not only requires proper antifungal administration but also management of electrolyte imbalances related to the administration. L-AMB is a life-saving drug provided it is used judicially and with utmost care.</p><p> </p>

<p class="abstract"><strong>Background:</strong> Mucormycosis is an uncommon but a fatal fungal infection that usually affects patients with altered immunity. Mucormycosis is proven to be a life-threatening condition. This occurred in the delta variant epidemic of coronavirus in India. This prompted us to conduct a systematic review of deaths in mucormycosis to know its temporal associations in relation to comorbidities, association with drugs being used in COVID-19 and overall characteristics of patients with its outcome.</p><p class="abstract"><strong>Methods:</strong> This retrospective study was conducted over 21 deaths out of 140 mucormycosis patients in the tertiary care centre between time period from May 2021 to July 2021. Based on the detailed history, clinical examination, endoscopic examination, blood investigations and radiological investigations, data was collected and analysed.  </p><p class="abstract"><strong>Results:</strong> In the study 19 patients were post covid and 2 were COVID positive at the time of admission to the hospital. 13 patients were having random blood sugars above 300 and 8 were having below 300 mg/dl. 13 patients had diabetic ketoacidosis. The maximum C-reactive protein (CRP) values was 200 and declined on treatment. The prothrombin time international normalized ratio (PT INR) values range between 0.99 and 1.3. Serum electrolytes were found to be normal in most of the patients. In the present study, 3 patients had electrolyte imbalance not responding to treatment. According to computed tomography/magnetic resonance imaging (CT/MRI) findings,12 had pansinusitis, 3 had pansinusitis with orbital cellulitis, 5 had pansinusitis with cavernous sinus thrombosis and 1 had pansinusitis with mandibular osteomyelitis.</p><p class="abstract"><strong>Conclusions:</strong> Early diagnosis, prompt treatment of comorbidities and immediate surgical debridement prevents death in mucormycosis patients.</p>