Mucocutaneous manifestations of COVID-19-associated mucormycosis: A retrospective cross-sectional study

Background: Cutaneous mucormycosis has shown a significant upsurge during the COVID-19 pandemic. Due to the rapid progression and high mortality of cutaneous mucormycosis in this context, it is important to identify it early. However, very few studies report detailed clinical descriptions of cutaneous mucormycosis in COVID-19 patients. Objectives: To describe mucocutaneous lesions of COVID-19-associated mucormycosis based on clinical morphology and attempt to correlate them with radiological changes. Methods: A retrospective cross-sectional study was conducted at a tertiary care centre from 1st April to 31st July 2021. Eligibility criteria included hospitalised adult patients of COVID-19-associated mucormycosis with mucocutaneous lesions. Results: All subjects were recently recovering COVID-19 patients diagnosed with cutaneous mucormycosis. One of fifty-three (2%) patients had primary cutaneous mucormycosis, and all of the rest had secondary cutaneous mucormycosis. Secondary cutaneous mucormycosis lesions presented as cutaneous-abscess in 25/52 (48%), nodulo-pustular lesions in 1/52 (2%), necrotic eschar in 1/52 (2%) and ulcero-necrotic in 1/52 (2%). Mucosal lesions were of three broad sub-types: ulcero-necrotic in 1/52 (2%), pustular in 2/52 (4%) and plaques in 1/52 (2%). Twenty out of fifty-two patients (38%) presented with simultaneous mucosal and cutaneous lesions belonging to the above categories. Magnetic resonance imaging of the face showed variable features of cutaneous and subcutaneous tissue involvement, viz. peripherally enhancing collection in the abscess group, “dot in circle sign” and heterogeneous contrast enhancement in the nodulo-pustular group; and fat stranding with infiltration of subcutaneous tissue in cases with necrotic eschar and ulcero-necrotic lesions. Limitations: The morphological variety of cutaneous mucormycosis patients in a single-centre study like ours might not be very precise. Thus, there is a need to conduct multi-centric prospective studies with larger sample sizes in the future to substantiate our morphological and radiological findings. Conclusions: COVID-19-associated mucormycosis patients in our study presented with a few specific types of mucocutaneous manifestations, with distinct magnetic resonance imaging findings. If corroborated by larger studies, these observations would be helpful in the early diagnosis of this serious illness.

Impact of delayed prosthetic treatment of velopharyngeal insufficiency on quality of life.

Palatopharyngeal dysfunction may take place when palatopharyngeal valve is unable to perform its own closing due to a lack of tissue (palatopharyngeal insufficiency) or lack of proper movement (palatopharyngeal incompetence). Palatopharyngeal insufficiency induces nasal regurgitation of liquids, hypernasal speech, nasal escape, disarticulations and impaired speech intelligibility. Prosthetic management of palatopharyngeal insufficiency requires a close co-operation between an otolaryngologist and a speech pathologist. As a result, the patient can be socially and physically rehabilitated with the improved speech quality as well as prevention of leakage of liquids.

Mechanical properties of denture base resins: An evaluation.

Background: Acrylic resin dentures are susceptible to fracture after clinical use, which is a problem of concern in prosthodontics. Impact failure outside the mouth and flexure fatigue failure in the mouth are two most important causes of fracture of denture base. Aim: This study evaluated the transverse deflection and transverse strength of four commercial brands of heat cure acrylic resin (Stellon, Acrylin-H, Trevalon and Trevalon-HI). Materials and Methods: An experimental design was adapted. Twenty-four rectangular strip specimens, six for each group, were prepared. Strips were finished on the edges and equally from the both the molded surfaces to make strips of specific dimensions. The tests were conducted mainly in accordance with the American Dental Association Specification no. 12/ISO: 1567-1981 (ISO: 6887-1986) for denture base polymer. The transverse deflection and transverse strength were measured by Instron testing machine. Intergroup differences were assessed using student "t" test. Results: The heat cure denture base material D (Trevalon "HI") had the minimum mean value of transverse deflection under different loads. Trevalon "HI" also had minimum value of mean transverse strength among different brands of acrylic resins. There was no statistically significant variation between Stellon, Acrylin-H and Trevalon, but variation was significantly higher with D (Trevalon "HI") vs. Stellon, Acrylin-H and Trevalon. Conclusion: The heat cure denture base material D (Trevalon "HI") was the strongest and C (Trevalon) was the weakest among all materials used in this study. The study showed that the deflection of various denture base resins (A to D) increases proportionately with the increase in load.