Background There is a sudden rise of fungal infection with corona virus disease. This is attributed to the immunomodulation by the disease and the drugs used, diabetes mellitus, steroid use, oxygen inhalation using dirty water, use of zinc and iron supplements, etc. Early diagnosis and prompt medical and surgical intervention is the mainstay of treatment. This can greatly reduce the high morbidity and mortality associated with this disease. The objective of the study is to describe the imaging findings of acute invasive rhino-orbito-cerebral mucormycosis (ROCM) in 25 patients with severe acute respiratory syndrome corona virus 2, from three different centers with proven mucormycosis. Special emphasis is placed on the signal enhancement patterns of sinonasal mucosa, the earliest and most common findings. Statistical analysis was performed using descriptive statistics. Results Computed tomography (CT) and magnetic resonance imaging (MRI) of 25 patients showed most commonly involved sinuses as maxillary and ethmoid sinuses (19, 76%) together. Sino-nasal mucosal thickening was the most common finding (24, 96%). Periantral infiltration (18, 72%) preceded before orbital (15, 60%), cerebral (5, 20%) and vascular (2, 8%) complications, with grossly intact bones. Sinus wall erosions were seen in only 2 patients (8%). Palatal (22%) and maxillary alveolar arch erosion (39%) were frequent findings. CT showed minimally enhancing hypodense soft tissue thickening as the predominant finding in involved areas, while MRI showed T1 and T2 iso- to hypointense mucosal thickening (62%) and intense (43%) and no (33%) contrast enhancement as the main finding. Conclusions Contrast enhanced MRI is better at demonstrating early mucosal abnormalities, turbinate necrosis, non-enhancing devitalized tissues, orbital apex involvement and intra-cerebral extension. Imaging findings of inflammatory tissue infiltration adjacent to the paranasal sinuses in premaxillary, retroantral fat, facial muscles, pterygopalatine fossa, temporal, infratemporal fossa and extraconal orbital fat along with typical patterns of sinonasal mucosal enhancement should raise the suspicion of acute invasive fungal etiology given the short duration of history and immunocompromised status. High incidence of periantral and orbital extension of the disease is suggestive of acute invasive form of fungal infection. Also the rapidly progressive inflammatory changes without much bone involvement should suggest the suspicion of ROCM. Bony, cerebral and vascular involvements are relatively late complications.

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Background: Patients with COVID-19 infection present with myriad of symptoms to the clinicians. Many of these patients undergo HRCT chest and various lab tests during their treatment. Correlation between various lab parameters and severity of the disease on chest CT would be helpful in management of such patients. In situations where CT is not available, lab parameters may help to predict disease severity. The primary objective was to find out if there was any correlation between CT severity scores and laboratory parameters in patients having COVID-19 and if one can be extrapolated in cases where CT facilities may not be available.Methods: This is a retrospective, descriptive, and observational study. CT severity scores were obtained in all the patients using the 25 point scale. The following lab parameters were assessed: TLC, DLC, SGOT, SGPT, CRP, D-Dimer, IL-6, Serum Ferritin and serum LDH. Correlation was done between the CT score and various lab parameters using Pearson correlation coefficient test.Results: 285 patients with positive COVID-19 RT-PCR test were included in the study. CT score showed statistically significant positive correlation with age, TLC, Neutrophil count, SGOT, SGPT, CRP, D-dimer, IL-6, Ferritin and LDH with p-values less than 0.05. Negative correlation was seen with Lymphocyte count. Severe disease was found to be more common in older patients.Conclusions: In our study, CRP, LDH, Serum ferritin, IL-6 and D-dimer levels were observed to have positive correlation with disease severity on CT.  Thus these measured at the time of admission can be taken into consideration to predict radiological severity.

Neural tube defects are developmental anomalies of the brain and spinal cord. They are typically diagnosed prenatally or shortly after birth. However, benign-appearing variants, such as an atretic meningocele, may go undiagnosed into adolescence or beyond. The authors report a rare case of atretic parietal cephalocele, a congenital anomaly of childhood that often goes misdiagnosed with poor prognosis. However, the prognosis largely depends on the presence or absence of associated anomalies.

Ovarian ectopic pregnancy (OEP) is a rare form of ectopic pregnancy (EP) and constitutes approximately 0.5-3% of all ectopic cases. Its presentation mimics the symptoms of tubal ectopic pregnancy, hemorrhagic ovarian cyst/follicle, tubo-ovarian abscess, urinary tract calculi, appendicitis or ovarian torsion. Occasionally determining the anatomic location of an extra-tubal ectopic pregnancy based on ultrasound imaging and presentation alone can be challenging, particularly when it is adherent to the fallopian tube. Although transvaginal ultrasound (TVS) is the primary modality used in the diagnosis, various forms of OEP and its complications may be incidentally detected and further evaluated on computed tomography (CT) or magnetic resonance imaging (MRI) when an alternative diagnosis is suspected. We reported a case of a second gravid para zero, 25 years old lady, who came with pain in the left lower abdomen. Her urine pregnancy test was positive. TVS showed empty uterine cavity, an extremely tender, heterogenous hyperechoic right adnexal mass, but no obvious gestation sac (GS). A large hematoma was detected adjacent to it in the pouch of Douglas (POD). Keeping a high suspicion of ectopic pregnancy, MRI was performed to evaluate the lesion better which revealed a natural, non-assisted, ruptured right ovarian ectopic pregnancy and was subsequently confirmed at laparotomy and proven on histopathology. Patient underwent left oophorectomy and discharged on 4th day with uneventful follow up.