Background Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case–control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM. Methods Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls. Results CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls. Conclusions Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Otitis media (OM) is a big menace in countries like India. Chronic suppurative otitis media (CSOM) is chronic inflammation of middle ear, which affects the tympanic membrane, middle ear mucosa and other middle ear structures characterised by the presence of persistent perforation or persistent mucoid or muco-purulent discharge for at least 8 weeks. Variety of organisms founds in patients suffering from chronic otitis media like, <em>Pseudomonas</em>, <em>Staphylococcus aureus</em>, <em>Proteus mirabilis</em>, <em>Klebsiella pneumonia</em> and <em>Escherichia coli</em> found. The pattern of organisms varies in different geographical areas. The objectives of the study were to isolate bacteria from patients with ear discharge, to find out antibiotic sensitivity of isolated organisms</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This is an observational cross sectional study done in the OPD department of otorhinolaryngology, at P.D.U medical college and hospital, Rajkot, for a period of six months from January 2017 to June 2017. A total number 200 patients of both gender between 5 to 74 years who visited the OPD department of otorhinolaryngology with chronic ear discharge taken for study.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 200 patients of 5-74 years with chronic suppurative otitis media were examined and out of this Hundred and twelve (54%) of the patients were males with mean age of 33.44. <em>Pseudomonas aeruginosa</em> was the commonest identified organisms the sensitivity pattern highly favoured Pipercillin, Amikacin and Polymyxin B, Cefoparazone. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Chronic otitis media is more prevalent in males than females. Commonest organisms found were <em>Pseudomonas aeruginosa</em> followed by <em>Staphylococcus aureus. </em>Piperacillin, Amikacin, Gentamicin, Polymyxin B and Cefoperazone were found most effective agents against <em>Pseudomonas aeruginosa</em>.</span></p>

<p class="abstract"><strong>Background:</strong> Deep neck spaces infection is a common challenging condition for otolaryngologist in day to day practice even after availability of higher antibiotics. It may leads to considerable morbidity and complications. The aim of the study was to find out prevalence, predisposing factors and changing trend of deep neck spaces infection in this broad spectrum antibiotics era.</p><p class="abstract"><strong>Methods:</strong> This prospective study was carried out at P.D.U. Medical College and Hospital, Rajkot. 120 Patients were studied who came with deep neck space infection.  </p><p class="abstract"><strong>Results:</strong> In this study majority of patient were in the age group of 41-60 year. Odontogenic and oropharyngeal infectionare the most common etiologies. <em>Staphylococcus aureus, Streptococcus, E. colli, Klebsiella</em> and anaerobes were the microorganisms commonly isolated in pus culture and sensitivity test.</p><p class="abstract"><strong>Conclusions:</strong> In spite of availability of broad spectrum antibiotics in present day deep neck spaces infection is the most commonly noticeable condition in developing countries and may lead to considerable morbidity and complications. Inadequate nutritional status, poor oral hygiene and lack of awareness in dental health are common predisposing factors for deep neck spaces infection.</p>

COVID-19 pandemic has led to a concerning surge of post-COVID-19 AIFR. Mucormycosis (BLACK fungus) is a rare but severe and life-threatening fungal infection occurred by mucormycetes, a family of moulds. More than 49,000 cases of AIFR were reported in three months in India. It primarily affects diabetics and spreads from the nasal cavity and paranasal sinuses (PNS). It also involves eye, palate, or brain. It is diagnosed clinically followed by radiological and pathological findings. We aimed to compare and analyse the pre-operative imaging with postoperative histopathological findings. The study was conducted in ENT department of tertiary care hospital, Rajkot. 200 patients were randomly selected who were presented to ENT OPD with clinically suspected Post COVID-19 AIFR. All patients underwent detailed ENT examination and radiological modality like MRI PNS, Brain, and Orbit. After proper pre-op evaluation, all patients underwent Functional Endoscopic Sinus Surgery (FESS). MRI findings were confirmed with that of histopathological findings done on KOH mount. All the patients were showing AIFR on MRI findings whereas 49% of patients had mucormycosis on Histopathology. Various other fungal infections like aspergillosis (7%), candidiasis (1.5%) were also found on HPE. 9% of patients showed combined infection with mucor and aspergillus species. Rest of the patients showed non-fungal rhinosinusitis. Inflow of the epidemic, plenty of patients were shown invasive fungal sinusitis in MRI patterns whereas many of them were HPE negative. Thus this study was done to know the efficacy of radiological features with pathological diagnosis. We have considered both procedures standard in our study.

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