COVID 19 infections may be associated with a wide range of bacterial and fungal co-infections. Mucormycosis is a fungal infection primarily affecting immunocompromised individuals. We have observed sudden rise of mucormycosis cases in post COVID 19 patients. Here we have reported 100 cases of mucormycosis associated with COVID 19. To study epidemiology and clinical features of rhino orbital mucormycosis in post COVID 19 patients. To evaluate efficacy of medical as well as surgical treatment in such patients. This was an observational mixed (retrospective + prospective) study with a duration of 2 months. After noting demographic data, necessary radiological investigation was advised and representative tissue was sent for KOH and histopathological examination. Medical and surgical treatment was planned accordingly. Most patients (55%) presented with complaint of headache and facial pain. Hard palate involvement was observed in 45% patients. Unilateral presentation (68%) was more common. Only 25% patients who presented early had normal vision. We reported 22 patients with complete loss of vision. Eye movements were restricted in 58% patients. Diabetes mellitus is most common predisposing factor (65%). 9 patients required orbital exentration. Only 18% patients required Amphotericin for more than 14 days. Immune dysregulation caused by COVID 19 infection in addition to widespread use of steroids and broad-spectrum antibiotics may lead to the development mucormycosis. Diabetes Mellitus type II is another important risk factor and the presence of both have additional effect in causing mucormycosis. Headache and facial pain should be considered highly suspicious of mucormycosis. Early diagnosis with efficient treatment can improve prognosis.
This prospective, double blind investigation was carried out to see the effect of vaginal pH on the efficacy of prostaglandin gel (PGE2) for cervical ripening and course of labour. A total of 45 pregnant women with indications for induction of labour were allocated to two groups: a low vaginal pH (≤5.5, n = 20) and high vaginal pH (>5.5, n = 25) group. All women received prostaglandin E2 gel (0.5 mg in 2.5 ml) intravaginally with repeated dosing if needed, 6 h apart, maximum of three doses. Bishop's score change over 18 h differed significantly between the two groups (p = 0.037). There was no significant difference between the groups with respect to time to onset of labour (9.65±6.29 vs 6.76±3.94, p = 0.066), time to active labour (15.38±9.49 vs 14.30±5.85, p = 0.664), time to complete cervical dilation (18.27±13.85 vs 18.34±6.45; p = 0.984), and time to overall delivery (21.52±9.66 vs 19.39±6.45, p = 0.381).
Introduction
Cut throat injuries are one of the challenging emergencies encountered in clinical practice. This study evaluates the causes and management of cut throat injuries.
Materials and Methods
This was a retrospective study of total 100 cases of cut throat injury presented to the department of ENT in a tertiary care hospital in Ahmedabad between June 2017 and June 2019. Majority of patients were managed by suturing.
Results
In our study 69% were males,31% were females. The peak age of incidence is 4th decade (55%). 70% of them have injury in Zone II. Seventy eight percent of the patients presented with active bleed without major vessel injury. The most common cause of cut throat injury had been found to be accidental (75%), 54% had injury up to muscular layer. Five patients were managed by laryngotracheal stent placement.
Conclusion
The middle aged males were mostly affected. The majority had zone 2 injury. The most common cause was Accidental (seasonal manja/ kite thread cut). Primary repair is the best way to avoid complications.
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