Bilateral Facial Nerve Palsy after Sars-Cov2 Infection in Pediatric Patient

COVID-19 infection has been associated with several neurologic manifestations including anosmia, acute ischemic stroke, Guillain-Barré syndrome, encephalopathy and cranial nerve involvement. Though multiple cases of unilateral facial nerve palsy have been reported but bilateral facial palsy is very rare. Our case was 12 years old female patient who presented with difficulty in closing mouth, drooling of saliva and change in voice. On examination, there was loss of bilateral nasolabial folds, nasal twang of speech and incomplete eye closure bilaterally. Laboratory reports suggested raised CRP and amylase along with positive Immunoglobulin IgG covid-19 antibodies. Magnetic Resonance Imaging of brain and neck showed no abnormality. The child was managed conservatively with supportive care, subsequent to which she gradually improved over next 4-6 weeks. To the best of our knowledge, this is the first pediatric case where SARS-COV2 infection was found to be associated with bilateral facial nerve palsy as a post covid complication. Therefore, bilateral facial palsy should be considered as one of the associations of COVID especially in the present era. A detailed history and examination should be done as it often gets missed due to bilateral involvement. All differential diagnosis should be ruled out by relevant laboratory & radiological tests. Most children are likely to recover well with supportive treatment.

Biological activity of Dolichos biflorus L. trypsin inhibitor against lepidopteran insect pests.

Protease inhibitors confer resistance in plants against insect pests by inhibiting larval gut proteases. Cultivars of Dolichos biflorus were screened for their inhibitory activity against midgut proteases of Pieris brassicae larvae. Seed extracts of developing and germinating seeds of HPK4 cultivar inhibited larval gut proteases of Spodoptera littoralis efficiently. Neonate larvae of P. brassicae fed on cabbage leaf discs coated with 0.025-2.50 mg protein (seed extract) resulted in 10-80% larval mortality and significantly reduced leaf area eaten and faecal matter as compared to control. The treated larvae had 40% less soluble proteins per mg faecal matter and there was similar decline in midgut proteases of treated larvae (@ 2.5 mg protein) compared to untreated ones after 5 days. The LC50 and LT50 value was calculated to be 1.05 mg/leaf disc and 4.8 days (2.5 mg protein), respectively for neonate larvae of P. brassicae. Significant reduction in egg hatching (75%) was observed in egg mass treated with 5.3 mg of crude inhibitor protein of mature seeds. This could be due to the inhibition of proteases involved in the hydrolysis of egg chorion proteins. The studies demonstrated the insecticidal activity of D. biflorus seed extracts.