Corneal manifestations and treatment among patients with COVID-19-associated rhino-orbito-cerebral mucormycosis

Purpose: TO report the corneal manifestations in patients with COVID?19?associated rhino?orbito?cerebral mucormycosis (ROCM). Methods: This study was a retrospective, observational, and record?based analysis of patients of ROCM with corneal involvement. Results: A total of 220 patients were diagnosed with ROCM over a period of 3 months. Thirty?two patients had developed corneal manifestations. The mean age at diagnosis was 52.84 ± 12.8 years. The associated risk factors were systemic mucormycosis, uncontrolled diabetes, recent COVID?19 infection, and injudicious use of systemic steroids. Twenty?nine patients were known diabetics, 32 had recent COVID?19 infection, and 13 gave a history of injudicious use of steroids. The right eye (RE) was affected in nine patients, the left eye (LE) in 20 patients, and both eyes in three patients. Nine patients had a round?oval corneal ulcer. One patient each had a perforated corneal ulcer with uveal prolapse, sealed perforated corneal ulcer, spontaneously healed limbal perforation, diffuse corneal haze with hyphemia, panophthalmitis, diffuse corneal stromal abscess, limbal ischemia, anterior uveitis with posterior synechiae, inferior corneal facet, and filamentary keratitis. Three patients each had a corneal melt and inferior conjunctival xerosis with chemosis. Orbital exenteration was performed in six patients. Five patients with corneal ulcers healed. Topical eye drops of amphotericin (0.5 mg/ ml) cycloplegic, antiglaucoma medications, and lubricant eye drops were started along with systemic antifungals. Conclusion: Central corneal ulcer was the most common manifestation of mucormycosis. A concentration as low as 0.5 mg/ml of amphotericin eye drops was effective in the treatment.

Hormonal fingerprints: A key to early diagnosis of caries.

Background: 6‑n‑propylthiouracil (PROP) is one of the widely used anti‑hyperthyroid drug used for the treatment of grave’s disease. A medicated tool despite being non‑invasive, economical and giving reliable results presented with some difficulties, which became prevalent in our subsequent studies, thus prompting us to formulate a new method for predicting oral health status and diseases like diabetes occurring in India. Aim and Objectives: The current paper would be focusing on the new biological marker‑Hormonal Fingerprint that is under trial to predict children for their caries risk susceptibility. Materials and Methods: A total of 250 children were selected of age group 6‑16 years and PROP sensitivity test was carried out by placing a strip on the dorsal surface of the subject tongue. The hormonal fingerprint was made by measuring the length ratio of the index and ring finger with the help of digital vernier caliper. Statistical Analysis Used: The statistical method employed to compute the results were Pearson’s Chi‑square test and analysis of variance. Results: Overall results suggested positive correlation between low second‑to‑fourth digit ratio(2D:4D), i.e. high prenatal androgen levels and high caries index in an Indian population. Conclusion: The research confirms the impact of hormones on human perception of taste and dietary preferences, which in turn influence their caries index and could also extend way beyond it.

Oral Cavity — A Window to Systemic Illness.

Oral cavity very often has been described as reflection of our body as most of the initial clinical symptoms occur in oral cavity. The current paper also focuses on the oral presentation of the systemic condition called Pyknodysostosis (MIM 265800) which is a rare, autosomal recessive skeletal dysplasia characterized by short stature, wide cranial sutures, and increased bone density and fragility was first described in 1962 by Maroteaux and Lamy under the heading of diastrophic dwarfism.

Physicochemical characterization and in vitro dissolution behavior of olanzapine-mannitol solid dispersions

The objective of the present work is to study the dissolution behavior of olanzapine from its solid dispersions with mannitol. Solid dispersions were prepared by melt dispersion method and characterized by phase solubility studies, drug content and in vitro dissolution studies. The best releasing dispersions were selected from release data, dissolution parameters and their release profiles. Solid state characterization techniques like Fourier transform infrared (FT-IR) spectroscopy, X-ray diffractometry, differential scanning calorimetry, near-infrared and Raman spectroscopy were used to characterize the drug in selected dispersions. The dispersions were also evaluated by wettability studies and permeation studies. The results of phase solubility studies and the thermodynamic parameters indicated the spontaneity and solubilization effect of the carrier. The release study results showed greater improvement of drug release from solid dispersions compared to pure drug, and the release was found to increase with an increase in carrier content. The possible mechanism for increased release rate from dispersions may be attributed to solubilization effect of the carrier, change in crystal quality, phase transition from crystalline to amorphous state, prevention of agglomeration or aggregation of drug particles, change in surface hydrophobicity of the drug, and increased wettability and dispersability of the drug in dissolution medium. The suggested reasons for increased release rate from dispersions were found to be well supported by results of solid state characterization, wettability and permeation studies. The absence of any interaction between the drug and the carrier was also proved by FT-IR analysis.

O objetivo do presente trabalho é estudar o comportamento de dissolução da olanzapina a partir de suas dispersões sólidas de manitol. As dispersões sólidas foram preparadas por dispersão por fusão e caracterizadas por estudos de solubilidade de fase, conteúdo de fármaco e dissolução in vitro. As melhores dispersões quanto à liberação foram selecionadas a partir dos dados de liberação, parâmetros de dissolução e perfis de liberação. Técnicas de caracterização de estado sólido como espectroscopia no infravermelho pela transformada de Fourier (FTIR), difratometria de raios X, calorimetria de varredura diferencial, infravermelho próximo e espectroscopia Raman foram utilizadas para caracterizar os fármacos a partir das dispersões selecionadas. As dispersões foram, também, avaliadas pelos estudos de capacidade de umedecimento e permeação. Os resultados dos estudos de solubilidade de fase e os parâmetros termodinâmicos indicaram a espontaneidade e o efeito de solubilização do transportador. Os resultados dos estudos de liberação mostraram maior aperfeiçoamento da liberação do fármaco das dispersões sólidas, comparativamente à do fármaco puro, e descobriu-se que a liberação aumenta com o aumento do conteúdo de transportador. O mecanismo possível para o aumento da taxa de liberação das dispersões pode ser atribuído ao efeito de solubilização do transportador, mudança da qualidade do cristal, transição de fase cristalina para estado amorfo, prevenção da aglomeração ou agregação das partículas do fármaco, mudança na superfície de hidrofobicidade do fármaco e aumento da capacidade de umedecimento e dispersividade do fármaco no meio de dissolução. As razões sugeridas para o aumento da taxa de liberação a partir das dispersões foram apoiadas pelos resultados da caracterização do estado sólido, capacidade de umedecimento e pelos estudos de permeação. A ausência de qualquer interação entre o fármaco e o transportador foi, também, comprovada pela análise no FTIR.