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.

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Hydrogen Sulfide (H2S), recently identified as the third endogenously produced gaseous messenger, is a promising therapeutic prospect for multiple cardio-pathological states, including myocardial hypertrophy. The molecular niche of H2S in normal or diseased cardiac cells is, however, sparsely understood. Here, we show that β-adrenergic receptor (β-AR) overstimulation, known to produce hypertrophic effects in cardiomyocytes, rapidly decreased endogenous H2S levels. The preservation of intracellular H2S levels under these conditions strongly suppressed hypertrophic responses to adrenergic overstimulation, thus suggesting its intrinsic role in this process. Interestingly, unbiased global transcriptome sequencing analysis revealed an integrated metabolic circuitry, centrally linked by NADPH homeostasis, as the direct target of intracellular H2S augmentation. Within these gene networks, glucose-6-phosphate dehydrogenase (G6PD), the first and rate-limiting enzyme (producing NADPH) in pentose phosphate pathway, emerged as the critical node regulating cellular effects of H2S. Utilizing both cellular and animal model systems, we show that H2S-induced elevated G6PD activity is critical for the suppression of cardiac hypertrophy in response to adrenergic overstimulation. We also describe experimental evidences suggesting multiple processes/pathways involved in regulation of G6PD activity, sustained over extended duration of time, in response to endogenous H2S augmentation. Our data, thus, revealed H2S as a critical endogenous regulator of cardiac metabolic circuitry, and also mechanistic basis for its anti-hypertrophic effects.

<p class="abstract"><strong>Background:</strong> The larynx serves protective, respiratory and phonatory functions in humans. Cancer of the larynx is common cancer of head and neck region. This study was done to determine the predisposing factors, clinical aspects and histopathological pattern of the laryngeal malignancies. Patients were studied with particular significance given to the mode of presentation, risk factors, topography and histopathology of the tumour.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted at Department of Otorhinolaryngology Head and Neck Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah. All 65 cases of laryngeal cancer presented from July 2016 to July 2017were included in this study.  </p><p class="abstract"><strong>Results:</strong> Most of cases belonged to age group 51-60 years. Tobacco intake in the form of smoking was the major risk factor and present in 80% of cases. Commonest presenting symptom was the dysphagia followed by hoarseness of voice. Supraglottic area was the commonest site (69.23%) for laryngeal cancer in this study. Squamous cell carcinoma was found in 98.46% of patients. Moderately differentiated category seen in 49.23% of patients. Most of the patients presented in the stage III and IV (30.77% and 44.62%). 37 (56.92%) cases out of 65 cases had cervical lymph node metastasis at the time of presentation.</p><strong>Conclusions:</strong>Diagnosis is based on proper history, clinical examination, direct visualization of the larynx, CT scan and established by histopathological examination. This study has been done to improve comprehension and care of patients with laryngeal carcinoma.<p> </p>