Mucormycosis in COVID‑19 Patients: A Tertiary Care Experience

Introduction: Zygomycetes consisting of Mucorales order is a group of fungal infections. These species cause life threatening opportunistic fungal infections mucormycosis. This infection is highly prevalent in immunocompromised. During the 2nd wave of Covid 19 pandemic corticosteroid treatment was used which has been linked to development of Mucormycosis. In our tertiary care teaching hospital we saw that patients suffering from Covid‑19 infections developed mucormycosis. We present these cases in our study. To study the clinical,demographical,and Laboratory parameters in Covid‑19 patients with Mucormycosis. Material and Methods: Retrospective Study. All biopsy proven cases of Mucormycosis (which developed after Covid‑19 infection) were included. Relevant Clinical Demographics and Laboratory data was retrieved from the available case sheets. The data was tabulated in Excel sheet and further reviewed. Results: A total of 22 patients were diagnosed as suffering from mucormycosis majority were unvaccinated. 11 patients out of 22 (50%) started manifesting mucormycosis within one week of COVID infection. All the patients who had only single comorbidity (22.72%) suffered from mild disease and patient who had more than one comorbidity suffered from moderate (27.27%) to severe (50%) COVID infection. Conclusion: It is suggested that patients with Covid‑19 infection are at risk for development of opportunistic fungal infections like Mucormycosis. Hence the physicians who are involved in treating such patients must be mindful of the fact that mucormycosis can develop in them. Histopathology helps in establishing a concrete diagnosis of Mucormycosis

An unusual case of adamantinoma of long bone

Adamantinoma of the long bones is an exceedingly rare and slow-growing tumor that affects the diaphysis of long bones, particularly the tibia. Based on the pattern of the epithelial cell component and the presence or absence of the osteofibrous dysplasia-like element, several histological variants have been described, such as (i) tubular (the most frequent), (ii) basaloid, (iii) squamous, (iv) spindle variant, (v) osteofibrous dysplasia -like variant, and (vi) Ewing's sarcoma - like adamantinoma (the least frequent). The diagnosis may be challenging since this tumor may be mistakenly interpreted as carcinoma, myoepithelial tumor, osteofibrous dysplasia, and vascular tumor. We report the case of a 41-year-old male who presented with swelling over the right leg associated with pain. The X-ray showed a lytic lesion of the right-sided tibia. The diagnosis of adamantinoma was made based on the clinico-radiological, histomorphology, and immunohistochemical findings. Histologically, classic adamantinoma is a biphasic tumor characterized by epithelial and osteofibrous components in varying proportions and differentiating patterns. The diagnosis can be confirmed by immunohistochemistry for demonstrating sparse epithelial cell nests when the radiological features are strongly consistent with adamantinoma. This case is highlighted because the epithelial component can lead to a misdiagnosis, particularly when the clinico-radiological features are overlooked. Adamantinoma of long bones has the potential for local recurrence and may metastasize to the lungs, lymph nodes, or other bones. The prognosis is good if early intervention is taken.

Clinicopathological Study Of Oral Cavity Mass Lesions In A Tertiary Care Centre Of North India

Background: Oral mass lesions, especially the potentially malignant and malignant lesions are a major health concern for a developing country like India. They pose a serious health and economic burden.Aims: This study was carried out to analyze the clinical profile and reaffirm the frequency of various causes causing mass lesions in oral cavity in different age-groups in a tertiary care centre of North India.Materials and Methods:All patients who had oral mass lesions and attended Departments of Otorhinolaryngology, General Surgery and the Dentistry of Hind Institute of Medical Sciences, Safedabad, Barabanki and Department of Surgery of School of Medical Sciences and Research, Sharda University, Greater Noida in two years (2015-2016) were included in the study.Statistical Analysis:All the analysis was carried out on SPSS 17.0 version (Chicago, Inc., USA). The results are presented in percentages. The Chi-square test was used to assess the associations between categorical variables. The p-value<0.05 was considered significant.Results:Of 126 cases with oral lesions, we found that 66 (52.4%) were benign, 12 (9.5%) were pre-malignant and 48 (38.1%) were malignant lesions. Squamous papilloma was the most common benign lesion followed by fibroepithelial hyperplasia. The premalignant lesions observed in our study in the decreasing order of frequency were leukoplakia, lichen planus and submucous fibrosis. The malignant lesions comprised of squamous cell carcinoma and verrucous carcinoma. Conclusion:In our study it was found that though the benign oral lesions are commoner that malignant but still these form significant numbers. Hence the origin and the nature of oral cavity lesion should not be decided on clinical assessment alone but should also take into account the histopathological evaluation of the lesion also.

Bioethanol production from sweet potato (Ipomoea batatas L.) flour using co-culture of Trichoderma sp. and Saccharomyces cerevisiae in solid-state fermentation

The aim of this work was to study the optimiation of co-culturing of Trichoderma sp. and Saccharomyces cerevisiae (1:4 ratio) on sweet potato (Ipomoea batatas L.) flour (SPF) for the production of bio-ethanol in solid-state fermentation (SSF). Maximum ethanol (172 g/kg substrate) was produced in a medium containing 80% moisture, ammonium sulphate 0.2%, pH 5.0, inoculuted with 10% inoculum size and fermented at 30ºC for 72h. .Concomitant with highest ethanol concentration, maximum ethanol productivity (2.8 g/kg substrate/h), microbial biomass (23×10(8) CFU/ g substrate), ethanol yield (47 g/100g sugar consumed) and fermentation efficiency (72%) were also obtained under these conditions. Cell interaction was observed familiar between the viable cells of Trichoderma sp. and S. cerevisiae when co-cultured. Ethanol production ability by the co-culture was 65 % higher than the single culture of S. cerevisiae from un-saccharified SPF.