Aims:
1
Describe the epidemiology and determine risk factors for COVID-19 associated mucormycosis.
2
Elaborate the clinical spectrum of Rhino-Orbital-Cerebral Mucormycosis (ROCM), pattern of neuroaxis involvement and it's radiological correlates.
Methods
Observational study. Consecutive, confirmed cases of mucormycosis (N = 55) were included. A case of mucormycosis was defined as one who had clinical and radiological features consistent with mucormycosis along with demonstration of the fungus in tissue via KOH mount/culture/histopathological examination (HPE). Data pertaining to epidemiology, risk factors, clinico-radiological features were analysed using percentage of total cases.
Results
Middle aged, diabetic males with recent COVID-19 infection were most affected. New onset upper jaw toothache was a striking observation in several cases. Among neurological manifestations headache, proptosis, vision loss, extraocular movement restriction; cavernous sinus, meningeal and parenchymal involvement were common. Stroke in ROCM followed a definitive pattern with watershed infarction.
Conclusions
New onset upper jaw toothache and loosening of teeth should prompt an immediate search for mucormycosis in backdrop of diabetic patients with recent COVID-19 disease, aiding earlier diagnosis and treatment initiation. Neuroaxis involvement was characterized by a multitude of features pertaining to involvement of optic nerve, extraocular muscles, meninges, brain parenchyma and internal carotid artery.
Abstract. Detection of individual luminous sources during the reionization epoch and cosmic dawn through their signatures in the HI 21-cm signal is one of the direct approaches to probe the epoch. Here, we summarize our previous works on this and present preliminary results on the prospects of detecting such sources using the SKA1-low experiment. We first discuss the expected HI 21-cm signal around luminous sources at different stages of reionization and cosmic dawn. We then introduce two visibility based estimators for detecting such signals: one based on the matched filtering technique and the other relies on simply combing the visibility signal from different baselines and frequency channels. We find that the SKA1-low should be able to detect ionized bubbles of radius R b 10 Mpc with ∼100 h of observations at redshift z ∼ 8 provided that the mean outside neutral hydrogen fraction x HI 0.5. We also investigate the possibility of detecting HII regions around known bright QSOs such as around ULASJ1120+0641 discovered by Mortlock et al. (Nature 474, 7353 (2011)). We find that a 5σ detection is possible with 600 h of SKA1-low observations if the QSO age and the outside x HI are at least ∼2 × 10 7 Myr and ∼0.2 respectively. Finally, we investigate the possibility of detecting the very first X-ray and Ly-α sources during the cosmic dawn. We consider mini-QSOs like sources which emits in X-ray frequency band. We find that with a total ∼1000 h of observations, SKA1-low should be able to detect those sources individually with a ∼9σ significance at redshift z = 15. We summarize how the SNR changes with various parameters related to the source properties.
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