ABSTRACT
Mucormycosis has emerged as an important fungal infection with high associated mortality rates. Mucormycosis causes devastating angio-invasive fungal infections, primarily in patients with underlying risk factors. The prevalence of mortality associated with invasive Mucormycosis is high (>30-50%), with 90% mortality contributed by disseminated disease. Sudden rise in Mucormycosis cases during the COVID-19 pandemic came as a surprise to all. Lowered immunity due to COVID and associated conditions like diabetes, made the population susceptible to this dreaded disease. This disease led to both increase in morbidity and mortality among the general population. Aim of the Study: To interpret in detail the causes of mortality of patients presenting with COVID Associated Mucormycosis (CAM-19) at AIIMS Patna between May-November, 2021. Material(s) and Method(s): An observational study of all patients who were treated for mucormycosis during the period of May 2021-Nov 2021 in ENT Department, AIIMS, Patna. During the period of study, 219 patients of Rhino-Orbital-Cerebral Mucormycosis (ROCM) were admitted for treatment. Five patients had gone on Leave Against Medical Advice (LAMA). So, 214 patients were included in the study. Result(s): Among the 214 patients, 165 patients were treated surgically through both endoscopic and open approaches along with antifungal therapy management. 41 patients died during the hospital course of the treatment. The mortality rate of ROCM stood at 19.15% in our series. Pulmonary Mucormycosis had high mortality (100%). Diabetes is the most common risk factor. Multiple co-morbidities and extensive intracranial involvement had a strong association with mortality. Conclusion(s): The advanced stage of ROCM was associated with more deaths. Our series mortality rate of 19.15% is lower than most of the other documented mortality rates. Our results support that early aggressive surgical approach, antifungal therapy and multidisciplinary approach has reduced the mortality.Copyright © 2022 Indian Medical Association. All rights reserved.
ABSTRACT
The emergence of social media has provided people with the opportunity to express their feelings and thoughts about everything and everything in their lives. There is a massive amount of textual stuff available, and approaches are required to make meaningful use of the information provided by isolating and evaluating the different types of text. Sentimental Analysis is a method of obtaining a human being's point of view through mining his or her emotions. The entire world is sharing their thoughts on social media on the Corona Pandemic that is now underway. This research presents an analysis of attitudes in order to determine whether or not people are optimistic in the face of a difficult circumstance. The technique of polarity is employed by the paper in order to determine if an opinion is positive, negative, or nonpartisan [1]. In order to determine the polarity, the following three major keywords are used: "COVID", "Corona virus," and "COVID-19."
ABSTRACT
Introduction: This study outlines the unique modifications to open surgical tracheostomies in COVID-19 intensive care unit (ICU) patients. Our main aims and objectives were to outline and assess the efficacy of unique modifications to open surgical tracheostomy procedure among severe COVID-19 patients in terms of the operative setup, anesthetic considerations, and surgical procedure. Method: An observational study was conducted between May 2020 and November 2020. The study group included patients who were in ICU due to severe COVID-19 symptoms and required tracheostomy. We conducted 85 surgical tracheostomies in severely sick ICU patients with certain novel modifications to achieve safe procedure for both the patient and the operating team. Modifications were done to reduce transmission in the form of shifting 1 portable operating table and a portable operating light by the bedside of patients in the ICU. These could be wheeled in to each ICU bedside, allowing a bedside tracheostomy to be performed without the need to shift the patient all the way to the operating theater. This had the following advantages: reduced viral exposure, better surgical environment, better comfort for operating surgeon, and better patient outcomes. There were certain modifications in surgical steps for COVID-19 tracheostomy, which were as follows: (1) procedure done under general anesthesia, (2) transient apneic tracheostomy, (3) carinal intubation, (4) avoiding utilization of cautery, (5) injection of intratracheal local anesthetic drug, (6) endotracheal tube clamping at end inspiration/ inspiratory hold, (7) use of inner cannula and closed suction unit, and (8) postoperative stoma site mask application. Results: Of the 85 open surgical tracheostomies, the number of transient intraoperative desaturation was 2. No intraoperative death was encountered, and no doctors acquired the COVID-19 infection despite doing up to 4 open surgical tracheostomies per day. Conclusion: The modified bedside open surgical tracheostomy discussed is a safe, resource-efficient, and cost-effective method of performing open surgical tracheostomy in the COVID-19 era while protecting our health care personnel from the viral exposure.