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.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Chronic suppurative otitis media is a disease affecting the middle ear and mastoid cavity, leading to considerable morbidity by causing hearing loss; and even life threatening complications in squamosal type of CSOM, if left untreated over long periods of time. Hence it is imperative to treat the persistent ear discharge in CSOM according to the antibiotic susceptibility of the organisms isolated. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is a prospective cross sectional study done in 135 patients of chronic suppurative otitis media presenting with active ear discharge. Sterile swabs were used to collect pus from discharging ear and sent for culture sensitivity.  </span></p><p class="abstract"><strong>Results:</strong> <em><span lang="EN-IN">Staphylococcus</span></em><span lang="EN-IN"> and <em>Pseudomonas aeruginosa</em> were the most common organisms isolated in this study. <em>Pseudomonas aeruginosa</em> was most sensitive to Piperacillin-Tazobactam, followed by Meropenem and Ciprofloxacin. <em>Staphylococcus aureus </em>was most sensitive to Linezolid followed by Cefoxitin and Erythromycin. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Treating active discharge of CSOM according to pus culture sensitivity pattern reduces the bacterial load in the middle ear and makes the ear more favourable for graft uptake.</span></p><p class="abstract"> </p><p class="keywords"><strong>Keywords: </strong><span lang="EN-IN">Chronic suppurative otitis media, Aerobic bacterial culture, Antibiotic susceptibility, <em>Pseudomonas aeruginosa</em>, <em>Staphylococcus aureus</em></span></p>

Primary mucosal melanomas arise from melanocytes located in occult sites and can present along the mucosal membranes lining respiratory, gastrointestinal, and urogenital tract. Sinonasal melanomas are extremely rare. Infrequent tumour incidence has limited the insight about their pathogenesis and associated risk factors along with indefinite protocols for staging and treatment of mucosal melanomas. We report here a case of primary melanotic tumour involving the nasal cavity, which was detected at an early stage and operated. We also describe the histological features, imaging studies, and treatment options for this tumour along with a brief literature review. KEYWORDSMucosal Melanoma, Nasal Tumours, Lateral Rhinotomy. Majority of the melanomas are cutaneous in origin. Cutaneous tumours can develop anywhere on the skin, but are more likely to start on the trunk, chest, and back) in males and on the legs in females. 3 Unlike cutaneous melanomas, primary mucosal melanomas arise from melanocytes located in occult sites and can present along the mucosal membranes lining respiratory, gastrointestinal, and urogenital tract. The sinonasal melanomas are extremely rare and accounts for less than 1% of all melanomas. The rarity of the mucosal melanomas have limited the understanding of possible risk factors and the pathogenesis of this disease resulting in inadequacy of precise treatment options. We report here a rare case of melanoma of nasal cavity, which was diagnosed at an early stage and operated and the biopsy of which affirmed to be malignant mucosal melanoma. We also briefly discuss about cases reported in the past along with a literature review. HOW TO CITE THIS ARTICLE:

Background: Fibroepithelial polyps are benign polypoidal lesion which arises from mesoderm. It is one of the most common cutaneous lesions. Fibroepithelial polyps are infrequently noted in the pharynx of an adult. We report a case of a 35 year old male patient who presented with foreign body sensation in the throat since 15 days. On examination a pedunculated polyp of about 3x1 cm was noted to arise from upper pole of left tonsil. Tonsillectomy was done under general anaesthesia and was sent for HPE which revealed fibroepithelial polyp of left tonsil. Fibroepithelial polyps of palatine tonsils are rare pedunculated benign lesions and have extremely low malignancy transformation.

<p class="abstract"><strong>Background:</strong> The aim of tympanoplasty done for tubotympanic type of chronic suppurative otitis media (CSOM) should not only be to achieve a dry ear, but also to give hearing improvement to the patient. Aim of this study was to determine the correlation between size and site of tympanic membrane perforation with degree of hearing loss and correlation between ossicular chain status and degree of hearing loss on pure tone audiometry.</p><p class="abstract"><strong>Methods:</strong> Patients with tubotympanic CSOM with hearing loss upto 60 dBHL undergoing tympanoplasty were examined to know the site and size of tympanic membrane(TM) perforation. Intraoperative findings pertaining to middle ear and ossicles were noted.  </p><p class="abstract"><strong>Results:</strong> Out of 52 patients of tubotympanic type of CSOM, hearing loss was least (31.18±7.46 dBHL) in small perforations of the TM and highest in subtotal perforations (48.74±7.83 dBHL) which was statistically significant. Hearing loss was significantly more in posterior perforation (46.61±7.02 dBHL) than in anterior perforation of TM (32.65±8.77 dBHL).<strong> </strong>There was a statistically significant difference in pure tone average hearing loss between intact ossicle group (32.87±9.77 dBHL)<strong> </strong>and eroded ossicle group (43.39±9.60dBHL). Difference in air bone gap was also significant between intact ossicle group (24.09±9.56 dB) and eroded ossicle group (31.02±9.83 dB). Multiple ossicles were eroded in nineteen patients with incus being the most commonly eroded ossicle.</p><p><strong>Conclusions:</strong> In this study, hearing loss increased with increased size of TM perforation and also with posterior perforation. Incus was found to be the most commonly eroded ossicle. Multiple ossicles were seen eroded most commonly when hearing loss was moderate. The surgeon will be better equipped to do ossiculoplasty in view of these preoperative findings and also to counsel the patient better about their expectation of hearing improvement following surgery. </p>